顺腋皱襞小切口直视下清除大汗腺治疗腋臭的临床体会.docVIP

顺腋皱襞小切口直视下清除大汗腺治疗腋臭的临床体会 　　摘要：目的 探讨顺腋皱襞小切口直视下清除大汗腺治疗腋臭的临床效果和体会。方法 对我科门诊99例腋臭患者应用顺腋皱襞皮纹小切口直视下修剪清除大汗腺治疗，对其疗效及临床表现进行观察分析。结果 99例患者 Ⅰ期愈合92例，瘢痕细小、隐蔽。Ⅱ期愈合7例，其中5例血肿形成、2例皮缘坏死。术后6个月后门诊随访或电话随访，治愈者76例、显效17例、有效2例、失访4例。患者无腋臭复发及其他并发症发生、效果满意。结论 顺腋皱襞皮纹小切口直视下修剪清除大汗腺治疗腋臭疗效满意、瘢痕细小、值得推广。 　　关键词：小切口；直视下；清除大汗腺 　　Abstract：Objective To approach the clinical efficacy and comprehension of orthophoric apocrine sweat gland curettage with minimal incision along axillary fold for osmidrosis. Methods 99 osmidrosis patients were underwent orthophoric apocrine sweat glands curettage with minimal incision along axillary fold， and then their therapeutic efficacy and clincal reactive manifest were observed and analysed. Results 92 of 99 osmidrosis patients had healed primarily with concealed tiny scar. 7 of 99 cases had healed secondly， but 5 patients occurrenced haematoma and 2 patients appeared necrosis at the incisal edge.All patients were followed up by outpatients or phone asking after 6 months underwent the curettage.And 76 patients with the healing well，17 sufferers with excellent effect， 2 victims only effective，but regret 4 patients were loss vist.All patients hadnt relapsed osmidrosis and without other complications occurrenced， so they feel content with this way of surgery treatment .Conclusion The curative effects were content with the orthophoric apocrine sweat gland curettage by minimal incision along axillary fold for osmidrosis，and the scar were tiny，so it would be deserved to spread using. 　　Key words：Minimal incision； Orthophoric； Curettage of apocrince sweat gland 　　我国腋臭发病率高达6.4%，患者女性多于男性，常有家族史[1]。腋臭对患者的生活时常带来烦恼，特别是夏季，常常给患者带来巨大的交往障碍。因腋臭是由大汗腺分泌物和皮肤细菌共同作用下产生的异味，所以彻底清除腋区大汗腺是多数学者公认的治疗腋臭的关键，是最常见的门诊手术。虽治疗的方法众多，但迄今为止，还没有一种令人十分满意的办法，非手术疗效欠佳，手术治疗疗效较肯定，但常有并发症发生。自2011年3月～2014年10月我科采用顺腋皱襞皮纹小切口直视下清除大汗腺治疗腋臭99例，取得了满意的效果，现报告如下。 　　1 资料与方法 　　1.1一般资料 本组患者99例，均符合腋臭诊断标准。男性35例、女性64例，年龄18～44岁，均为双侧腋臭，其中3例曾行激光治疗无效，5例曾行其他手术方式治疗效果不满意。所有患者均给予常规术前检查，排查手术禁忌症后择期手术。 　　1.2方法 　　1.2.1术前准备 患者术前清洗腋部，取平卧位，双上肢