小切口修剪顶泌汗腺治疗腋臭技术要点探讨.docVIP

小切口修剪顶泌汗腺治疗腋臭技术要点探讨 　　[摘要]目的:探讨小切口修剪顶泌汗腺治疗腋臭的技术要点。方法:从2005年1月至2009年6月笔者应用小切口修剪顶泌汗腺治疗腋臭128例(女性88例,男性40例),所有患者均获随访,最短时间为6个月。结果:128例中,117例患者获满意疗效, 5例出现切口边缘5mm以内皮肤坏死,3例发生单侧血肿,3例单侧气味残留。术后组织病理学检查显示:顶泌汗腺主要位于皮下浅层,少量位于真皮深层。结论:小切口修剪顶泌汗腺治疗腋臭不仅可获得满意的疗效,而且有良好的形态效果。 　　[关键词]腋臭;顶泌汗腺;小切口 　　[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2010)08-1115-03 　　 　　Technical key points of treating for axillary osmidrosis by mini-incision subdermal excision of apocrine gland 　　CHEN Jian-ming1, YANG Zhen-sheng2 , HUANG Hai-bin1 　　(1.Department of Plastic Surgery, Peoples Hospital of Futian District, Shenzhen 518033, Guangdong, China) 　　 　　Abstract: Objective To study technical key points of treating for axillary osmidrosis by mini-incision subdermal excision of apocrine gland. MethodsFrom January of 2005 to June of 2009, 128 patients (88 female, 40 male)with axillary osmidrsis had been treated by mini-incision subdermal excision of apocrine gland.All patients were followed up for a minimum 6 months. ResultsOf the 128 patients, 117 patients had good results, 5 patients underwentnecrosisof skin margin (5mm), 3 patients developed a unilateral hemotoma, and 3 patients had a unilateral recurrence of odor to some degree. Histopathology reveal most of apocrine located in the subcutaneous tissue near the border to the dermis and very few apocrine were found in the dermis. Conclusion This surgical procedure is not only effective for treating osmidrosis but also can meet the requirement of aesthetic results. 　　Key words: osmidrosis;apocrine;mini-incision 　　 　　腋臭是由于腋窝顶泌汗腺过度分泌而产生令人不快气味的一种病症,其易引起社会和心理问题。目前手术治疗腋臭是疗效最为可靠的方法。随着社会发展,人们追求形态美的意识不断提高,过去一些传统的术式逐渐难以被患者接受。为了探讨一种形态与功能统一的术式,我科自2005年1月至2009年6月采用小切口修剪顶泌汗腺治疗腋臭患者128例,获得满意疗效,现将相关技术要点报导如下。 　　 　　1临床资料 　　本组患者128例,女性88例,男性40例,年龄特18～45岁,均为双侧,其中5例为激光无效,4例为“微创手术”后仍有异味。 　　 　　2手术方法 　　2.1 设计:患者平卧,双上肢外展、屈肘、抱头,剃去腋毛。用甲紫沿腋毛区边缘外1cm处标记术区,于腋顶部皱襞内画一条长3cm的切口线,用2%碘酒固定所画设计线。 　　2.2 麻醉:取2%利多卡因15ml,加入0.9%氯化钠溶液85ml,浓度为0.3%,肾上腺素为1:200 000,术区皮下浸润注射,一侧麻药用量约50ml。 　　2.3 操作方法