微创法及传统手术方法治疗腋臭临床比较.docVIP

微创法及传统手术方法治疗腋臭临床比较[摘要]目的:比较微创法和传统手术方法治疗腋臭的临床疗效及术后并发症。方法:应用小切口微创法治疗腋臭212例，应用传统的梭形切除术＋切口Z成形术治疗腋臭60例，术后将这两种方法的临床疗效和并发症进行比较。结果:应用小切口微创法治疗的病例中，其中出现切口部分裂开1例，皮下血肿13例，皮瓣部分坏死3例，术后23例残留轻度异味；应用传统的梭形切除术＋切口Z成形术治疗的病例中，其中出现切口部分裂开者5例，术后均无异味残留。结论:小切口微创法治疗腋臭，术后瘢痕不明显，但臭味去除可能不完全；传统的梭形切除术＋切口Z成形术治疗腋臭，臭味去除彻底，但术后瘢痕较长、明显。此两种方法治疗腋臭各有利弊，可根据患者的具体情况和要求选择手术方法。 [关键词]腋臭；小切口；Z成形术 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2008)06-0920-02 Clinical comparison between treatment of bromihidrosis LI Chang-gen,LI Xiao-jun,HU Xiu-mei,ZHANG Hua-sheng (Department of Plastic Surgery, Shenzhen People?s Hospital, Shenzhen 518020,Guangdong, China) Abstract:ObjectiveTo compare the clinical outcomes and complication between the treatment of bromihidrosis with two different methods.Methods212 patients were applied to the small incision surgical therapy.60 patients were applied to the conventional surgical therapy and Z-plasty. The clinical outcomes and complication of both groups were compared six months after the treatment. ResultsThere were 1 case with incision split, 13 cases with hematoma,3 cases with partial flap necrosis ,23 cases with slightly odor in the the small incision surgical therapy. There were 5 cases with incision split and no odor was remained in any case with the conventional surgical therapy and Z-plasty. Conclusion Each method has its advantage and disadvantage.We can choose the method according to different case. Key words:bromihidrosis;small incision;Z-plasty 腋臭俗称“狐臭”，是因为腋窝大汗腺分泌的汗液不仅含有各种电解质，还含有脂肪酸、蛋白质和糖，经皮肤表面的细菌分解成脂肪酸，从而形成特殊臭味，轻则造成患者心理负担，自我封闭，社交恐惧，重则严重影响患者的生活和工作。自2000 年3月～2007年10月，我们分别应用小切口微创法和传统的梭形切除术＋切口Z成形术治疗腋臭共272例，现将这些病例的治疗效果和术后并发症报道如下。 1临床资料 本组共272例（男53例，女219例），均为门诊病例，年龄18～32岁，平均22岁。应用小切口微创法212例，其中13例曾接受激光治疗；应用传统的梭形切除术＋切口Z成形术60例，其中8例曾接受小切口微创治疗。 2手术方法 2.1 小切口微创法：术前用美蓝沿腋毛边缘画线，确定手术范围，并用碘酊固定画线，以防消毒时标记被清洗。腋窝手术区局部肿胀麻醉,在腋毛范围内顺皮纹做1～2个长约2～3cm切口,深及浅层脂肪下，用组织剪将皮瓣的脂肪及真皮深层去除,直至皮瓣呈中厚皮片，切口间断缝合。于手术区外约1cm处,四周缝线6～8条,按植皮法打包加压包扎,肩关节制动，术后3天拆除打包，继续加压包扎，12～14天拆线。 2.2 梭形切除术＋切口Z成