二种术式治疗腋臭的临床与病理观察-外科学专业论文.docxVIP

摘 要 二种术式治疗腋臭的临床与病理观察 研究生：马博 导师：于冰 副教授 摘 要 目的：对腋臭患者分别进行小切口搔刮法、大汗腺修剪法治疗，寻找安全有效、 复发率更低的祛除腋臭的手术方法。方法：2009 年 6 月-2010 年 5 月间手术治疗 90 例腋臭患者，按照随机数字表分为 2 组，每组各 45 例，其中Ⅰ组 45 例，双侧发病 23 例共计 68 个腋臭部位；Ⅱ组 45 例，双侧发病 31 例，共计 76 个腋臭部位。分别 采用小切口搔刮法、大汗腺修剪法二种不同的清除大汗腺的手术方法，随访 3 月至 6 月。对手术前后的气味、病理切片大汗腺残留、疤痕是否明显、固定时间长短和其 他的外科并发症（如血肿、皮瓣坏死、伤口裂开和切口感染等）等进行对比。结果： 大汗腺修剪法治疗组的复发率和病理切片大汗腺残留率均低于小切口搔刮治疗组， 两者在术后并发症发生率上的差别没有统计学意义。但小切口搔刮法术后疤痕不明 显，术后固定时间少于大汗腺修剪法治疗组。结论：大汗腺修剪法治疗腋臭复发率 和病理切片大汗腺残留率均低，是目前手术治疗腋臭的一种较为理想的方法。 关键词：腋臭；皮下搔刮；大汗腺修剪；病理 新疆医科大学医学硕士学位论文 Clinical and pathological investigation of two kinds of surgical treatment of axillary osmidrosis Postgraduate: Mabo Supervisor: Yu bing associate professor Abstract Objective: The purpose of this study was to seek a more effective and a lower recurrence rate surgical procedure by comparing the method of subcutaneous curettage with apocrine sweat gland pruning .Method: From June 2009 to May 2010, 90 patients were selected and separated into two groups randomly. The patients of two groups underwent the different surgery that was subcutaneous curettage and apocrine sweat gland pruning respectively. They received follow-up visit 3month to 6month. Five parameters: odor, the pathological slices apocrine gland remain rate, scar, immobilization time, and other surgical complications such as hematoma, flap necrosis, wound dehiscence and infection of incisional wound were investigated and compared in two groups.Results: The group that underwent apocrine sweat gland pruning had the lower recurrence rate(2.6%)and pathological slices apocrine gland remain rate(7.9%)for malodor. However, the disadvantages of this procedure included wide scar and a long immobilization time(7-13days). subcutaneous curettage had advantages such as small invisible scars, a short-term immobilization time(3-5days), but it had a high rate of dissatisfaction postoperative malodor(16.2%) and pathological slices apocrine gland remain rate(22.1%). The incidence rate of surgical complications of two