腋窝小切口盲视下皮瓣修剪术联合搔刮术治疗腋臭  

The treatment of bromhidrosis with flap trimming through small axillary incisions combined with scraping techniques

作　　者：李习荣[1] 王玉龙 袁朝永 张宏图[1] 李岩[1] 张志华[1] Li Xirong;Wang Yulong;Yuan Chaoyong;Zhang Hongtu;Li Yan;Zhang Zhihua(Department of Plastic Surgery,Jining First People's Hospital,Affliated to Shandong First Medical University,Jining272000,China)

机构地区：[1]山东省第一医科大学附属济宁市第一人民医院整形科,济宁272000

出　　处：《中华整形外科杂志》2024年第5期530-536,共7页Chinese Journal of Plastic Surgery

摘　　要：目的探讨腋窝小切口盲视下腋部皮瓣修剪联合搔刮术治疗腋臭的临床效果。方法从2021年6月至2022年12月济宁市第一人民医院整形科就诊的双侧腋臭患者中选取研究对象,采用左、右侧腋窝自身对照的方法进行研究,两侧术式采用随机数表法分配,一侧采用腋窝上下两侧小切口盲视下腋部皮瓣修剪联合搔刮术(A组),一侧采用腋窝中部切口直视下腋部皮瓣修剪术(B组)。A组于腋窝上下两侧设计2条长0.5~1.0 cm切口线,切开皮肤全层并分离,通过2个切口盲视下交叉修剪腋部皮瓣顶泌汗腺和浅层脂肪组织,再用腋臭刮匙紧贴真皮深层刮除残存汗腺,术区留2个引流口,使2根引流条与手术切口贯穿;B组于腋窝中部设计2条长3~4 cm切口线,切开分离后直视下修剪腋部皮瓣顶泌汗腺和浅层脂肪组织,术区留置4根引流条。疗效评估:(1)术后1个月评价近期疗效,包括治愈、显效、无效3个等级;(2)术后6个月统计腋臭复发情况;(3)统计并发症情况。应用SPSS 25.0软件处理数据,2组间有效率、复发率、并发症发生率比较采用χ^(2)检验,P<0.05为差异有统计学意义。结果共纳入62例双侧腋臭患者,其中男38例,女24例,年龄16~35岁。A组治愈55例,显效7例,有效率为100%;术后6个月复发5例,复发率为8.1%;发生皮瓣下血肿1例、皮瓣表皮糜烂2例、瘢痕增生1例,并发症发生率为6.5%;B组治愈58例,显效4例,有效率为100%;术后6个月复发3例,复发率为4.8%;发生皮瓣下血肿4例、皮瓣表皮糜烂4例、皮瓣坏死2例、瘢痕增生4例,并发症发生率为22.6%。A、B 2组治疗有效率(χ^(2)=0.34,P=0.559)、术后复发率(χ^(2)=0.53,P=1.000)比较,差异均无统计学意义;A组并发症发生率明显低于B组(χ^(2)=6.50,P=0.011)。结论腋窝小切口盲视下腋部皮瓣修剪术联合搔刮术治疗腋臭临床效果好,可以达到较高的有效率,且并发症比腋窝中部切口直视下腋部皮瓣修剪术�Objective To conduct the clinical effect achieved by the combination of axillary flap trimming and scraping through small axillary incisions in treating bromhidrosis.Methods From June 2021 to December 2022,a study was conducted on patients with bilateral bromhidrosis in the Department of Plastic Surgery,Jining First People’s Hospital.The study used a self-control method,with one side undergoing axillary flap trimming combined with scraping through small axillary incisions(designated as Group A),while the other side underwent direct axillary flap trimming through central axillary incisions(designated as Group B).Randomization was achieved using a number table method for both sides.In Group A,two short incision lines of 0.5-1.0 cm were designed on both sides of the armpit.These incisions separated all layers of the skin,and excised the sweat glands and fat tissue.Additionally,two drainage openings were left in the surgical area to maintain two drainage tubes through the surgical incision.In Group B,the incision lines of 2-3 cm were designed in the central axillary area.After incision and dissection,four drainage tubes were retained in the operation area.The efficacy evaluation consisted of three aspects:the surgical outcome one month post-operation,categorized as cure,effective,or ineffective;the recurrence of bromhidrosis six months post-operation;and the occurrence of surgical complications.SPSS 25.0 software was used for data analysis,and chi-square test was applied for the comparisons between the two groups in terms of response rate,recurrence rate,and complication rate.A statistically significant difference was determined at the P<0.05 level.Results A study was conducted on 62 patients,aged between 16 and 35 years,with bilateral bromhidrosis,including 38 males and 24 females.In Group A,55 patients achieved complete cure,while 7 patients experienced significant improvement,resulting in an overall effectiveness rate of 100%.However,5 cases of recurrence were observed,with a recurrence rate of 8.1%.Additionally

关 键 词：外科手术 腋臭 小切口 盲视 搔刮 

分 类 号：R758.741[医药卫生—皮肤病学与性病学]