皮下修剪联合射频治疗腋臭临床研究.doc

皮下修剪联合射频治疗腋臭临床研究[摘要]目的：评价皮下顶泌汗腺剪除联合术中射频凝固治疗腋臭的临床效果。方法：根据皮肤组织的血供和顶泌汗腺的解剖学基础，设计小切口剪除皮下组织和毛囊，破坏顶泌汗腺的导管部分，应用射频凝固器发出射频功率，即双极电凝彻底止血的同时连续点击腋窝处残留的皮下脂肪层内的腺体部分，使之凝固坏死。修剪成的真皮下血管网超薄皮瓣原位缝合。结果：391例患者皮瓣全部成活，术后随访1年，有12例单侧术后半年仍有异味残留，再次手术，未见复发，治愈率为96.9%，有效率为100%。切口瘢痕不明显，上肢活动无影响。结论：皮下顶泌汗腺剪除联合术中射频凝固治疗腋臭是有效的方法，可直视下直接破坏顶泌汗腺，手术彻底，操作简单，有手术切口小，术后切口瘢痕不明显，临床效果满意等优点。 [关键词]皮下修剪；射频；腋臭 [中图分类号]R758.41+1R622 [文献标识码]A [文章编号]1008-6455（2008）10-1510-02 Clinical analysis of subcutaneous scissor and radio frequency solidify forbromhidrosis ZHANG Bin (Department of Dermatoplastic Surgery, Dalian Dermatological Hospital,Dalian 116021,Liaoning,China) Abstract: Objective To evaluate the clinical effects of subcutaneous scissor and radio frequency solidify for bromhidrosis. MethodsBased on the applied anatomy of skin and apocrine sweat glang, small incision scissor subcutaneous tissue and hair were devised to eradicate subcutaneous duct of apocrine sweat glang. To utilize electric solidifing machine for solidifing and eradicating apocrine sweat glang of subcutaneous tissue. Super-thin skin flaps were sutured in the former site. ResultsAll the skin flaps of these 391 cases survived after following up for 1 year, 12cases were recur after half a year, cure rate was 96.9%, effetive rate was 100%. the outline and function were good after operation.Conclusion The small incision sweat glang subcutaneous scissor and solidify for bromhidrosis is good and safe, Apocrine sweat glang can be conveniently eradicated. So it`s an ideal method to treatment bromhidrosis。 Keys words:subcutaneous scissor;radio frequency solidify;bromhidrosis 腋臭为皮肤外科和美容整形外科常见疾病，往往与遗传有关，不少患者有家族史。多在青春期发病，由于出汗时散发出异味，因而患者心理压力较大，影响正常社交以及日常生活和工作。我科自2002年5月～2007年5月通过皮肤小切口修剪皮下组织及毛囊联合射频凝固治疗腋臭391例，有手术切口小，术后切口瘢痕不明显，可直视下直接剪除和破坏顶泌汗腺，手术较为彻底，操作简单，术后效果满意等优点。现报道如下。 1资料和方法 1.1临床资料：本组391例患者（男104例，女287例），年龄13～48岁，平均23岁。所有患者均使用过各种外用药物，其中激光治疗15例，电离子9例，药物注射治疗4例，小切口皮下顶泌汗腺刮除术23例，腋毛区皮肤梭形切除直接缝合术9例，均治疗不满意。 1.2治疗仪器：RF-Ⅰ型射频双极凝固器，上海市技术监督局实验工厂生产