大汗腺盲视下刮除及直视下剔除两种方式治疗腋臭临床对比探究.doc

大汗腺盲视下刮除及直视下剔除两种方式治疗腋臭临床对比探究[摘要] 目的：比较和分析大汗腺盲视下刮除术与直视下剔除术治疗腋臭的临床效果及安全性。方法：2006年1月至2009年7月间在我科行腋臭微创手术并成功随访的346名患者共692侧，按手术方式分为盲视下刮除组和直视下剔除组，统计并比较各组近远期并发症和两年后异味残留情况。结果：盲视下刮除组106侧中，出现并发症10侧（9.4%），其中近期并发症有血肿（7侧）和伤口延迟愈合（1侧），远期并发症为皮下包块形成伴感染（2侧）；直视下剔除组586侧中，出现并发症共119侧（20.3%），其中近期并发症有血肿（56侧）、伤口裂开（18侧）、皮肤坏死（9侧）和伤口延迟愈合（11侧），远期并发症有皮下包块形成伴感染（8侧）、瘢痕增生（16侧）和肩关节活动受限（1侧），直视下剔除术并发症发生率高（P0.01）。上述并发症通过及时处理后皆愈合良好。术后两年随访，仍有异味残留者中，盲视下刮除术组（26侧，24.5%）较直视下剔除术组（43侧，7.3%）多（P0.01）。结论：两种方法对腋臭的治疗都是安全有效的，盲视下刮除术并发症发生率低，但直视下剔除术远期效果好，术后并发症通过合理而及时的措施都可以得到有效的预防和处理。 [关键词]微创腋臭手术；临床效果；比较分析 [中图分类号]R758.74 [文献标识码]A [文章编号]1008-6455（2012）02-0203-03 Comparison of clinical efficacy between blind scraping and direct excision of apocrine sweat glands for the Micro-invasive treatment of axillary osmidrosis GUO Ke,SUN Jia-ming,FENG Xiao-ling,GUO Neng-qiang,LIU Jia-feng (Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022,Hubei,China) Abstract: Objective To compare the clinical efficacy and safety of blind scraping and direct excision of apocrine sweat glands for the micro-invasive treatment of axillary osmidrosis. Methods 692 sides of 346 patients with axillary osmidrosis were treated with micro-invasive surgery in our department from January 2006 to July 2009 and successfully followed up. They were divided into blind scraping group and direct excision group, and the conditions of complications and odor residual in two years were noted and analyzed. Results There were 106 sides in blind scraping group,10 sides of them were complicated (9.4%),including hematoma (7 sides),delayed incision healing (1 side),and subcutaneous mass with abscess (2 sides). 119 sides of 586 sides in direct excision group were complicated (20.3%),including hematoma (56 sides), incision dehiscence (18 sides),skin necrosis (8 sides),scar hypertrophy (16 sides) and restricted shoulder movement (1 side). The complication rate of direct excision group was significantly higher