腋臭失败手术采用负压吸引方法再次治疗疗效研究.docVIP

腋臭失败手术采用负压吸引方法再次治疗疗效研究[摘要]目的:评价腋臭术后复发者再次进行微创负压抽吸术治疗的有效性和安全性。方法:对曾经实施微创手术疗效不佳的患者32例(女性21例,男性11例),采用负压抽吸术再次治疗,记录术后并发症,患者满意度和医生对手术评估等,与首次实施负压抽吸术的腋臭患者382例(女性253例,男性129例)进行对比分析。结果:两组病例术后疗效和并发症无统计学差异。术后满意率再次手术组和首次手术组分别为91% vs 93%(P0.05);没有发生严重并发症;再次手术组有5例(16%)因真皮和皮下脂肪瘢痕粘连导致操作困难。结论:微创负压抽吸术治疗腋臭及术后复发者同样有效,副作用少,值得临床推广应用。 [关键词]腋臭;抽吸术;微创 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)01-0018-03 Repeat liposuction-curettage for failed bromhidrosis surgery ZHENG Ze,GUO Yong-gang,SUN Zhi,LI Wen-zhi (Department of Plastic Surgery,Beijing Anzhen Hospital of the Capital University of Medical Science,Beijing 100029,China) Abstract:ObjectiveTo investigate efficacy and side-effects of a second Liposuction-curettage(LC) in patients with insufficient prior surgery for bromhidrosis.Methods32 nonresponders to prior minimally invasive surgery (21 female and 11 male) underwent a second LC. Side-effects, patient satisfaction, the surgeons’ intraoperative evaluation after surgery were documented,to compared with 382 patients of first LC(253 female and 129 male). ResultsThere were no significant differences in therapeutic effect and complications. In second LC,91% of all patients were satisfied with postoperative results(vs 93% in first LC,P0.05). No severe side-effects were observed. Five patients (16%) slightly increased difficulties during dissection of dermis from subcutaneous fat in second LC.ConclusionLC is effective for patients with insufficient response to prior minimally invasive surgery, with less side-effects, deserved to clinical application. Key words:bromhidrosis; liposuction-curettage; minimally invasive 腋臭普遍认为是在遗传的基础上,由大汗腺分泌的无臭味的乳状液,排出后被腋窝部位的表皮葡萄球菌、革兰氏阴性杆菌等细菌分解而产生短链脂肪酸而发出的特异性臭味[1]。目前手术治疗是根治腋臭的唯一方法,其中整形美容外科采用微创负压吸引手术方法获得了好的疗效[2],但临床上仍有一部分手术后效果不佳的患者来就诊。对于这些术后复发的腋臭患者,笔者再次选择负压抽吸术来治疗。再次负压吸引方法治疗腋臭手术失败的患者是否安全有效,目前尚缺乏足够的证据。因此,笔者采用与同期进行首次抽吸术的腋臭患者进行对比,分析再次抽吸术的疗效和安全性。 1材料和方法 1.1 病例资料:2002～2008年期间有32例患者(女性21例,男性11例)因腋臭手术治疗后疗效不满意于我院就诊,其中22例为肿胀负压抽吸术后(5例为我院手术后复发病人,其余为外院术