三种方法治疗腋臭的临床分析

发布时间：2018-03-11 00:11

本文选题：腋臭　切入点：A型肉毒毒素　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究采用A型肉毒毒素局部注射、小切口大汗腺剪除术、微创负压抽吸术这三种方法分别治疗腋臭,从术后疗效、术后并发症、术后复发率等多方面综合比较和评估,旨在给腋臭患者选择治疗方式时提供指导,提高腋臭治疗的满意度。方法:自2015年4月-2016年6月间的92例腋臭患者,分别采用A型肉毒毒素局部注射、小切口大汗腺剪除术、微创负压抽吸术这三种腋臭治疗方法进行治疗,并随访6至9个月。收集患者资料(年龄、性别、腋臭程度等)、术后疗效、术后并发症(如瘀青、血肿、皮肤坏死、切口裂开、局部感染、局部麻木和瘢痕挛缩等)、术后复发率等方面的资料,并进行统计学分析。结果:A型肉毒毒素局部注射组(A组)、小切口大汗腺剪除术组(B组)、微创负压抽吸术组(C组)三组间年龄、性别及腋臭严重程度均采用x2检验,分别为x2=24.12,P=0.84,x2=0.12,P=0.94,x2=0.16,P=0.997,P值均大于0.05,说明年龄、性别及腋臭严重程度在三组间的差异无统计学意义。对三组疗效进行统计学分析,轻度腋臭三种方法的有效率均为100%,无差异。三种治疗方式对中度腋臭的疗效分别为87.5%、92.3%、87.5%,进行x2检验,x2=1.59,P=0.452,P0.05,差异无统计学意义。三种治疗方式对重度腋臭的疗效分别为57.1%、84.6%、62.5%,进行x2检验,x2=19.54,P0.01,有显著统计学差异;再分别每两组对重度腋臭疗效进行x2检验,A组与B组(x2=18.31,P0.01)及B组与C组(x2=12.55,P0.01)有显著统计学差异;而A组与C组(x2=0.61,P=0.436,P0.05)差异无统计学意义。三组并发症总发生率分别为2.2%、25%、10.9%,行x2检验,x2=23.88,P0.01,有显著统计学差异。再分别每两组并发症总发生率进行x2检验,A组与B组(x2=22.12,P0.01)及B组与C组(x2=6.75,P=0.009,P0.01)有显著统计学差异;A组与C组(x2=6.18,P=0.013,P0.05)有统计学差异。三组半年内复发率分别为78.9%、0.0%、10.5%,行x2检验(x2=175.50,P0.01)有显著统计学差异;再分别每两组复发率进行x2检验,A组与B组(x2=130.31,P0.01),B组与C组(x2=11.08,P=0.001,P0.01)及A组与C组(x2=94.64,P0.01)均有显著统计学差异。结论:1.疗效方面,对于轻度和中度的腋臭,三种方法的有效率无明显差异,对于重度腋臭,小切口大汗腺剪除术优于其它两种治疗方式。2.并发症的发生率方面,小切口大汗腺剪除术最高,微创负压抽吸术次之,A型肉毒毒素局部注射最低。3.术后半年内复发率方面,小切口大汗腺剪除术最低,微创负压抽吸术次之,A型肉毒毒素局部注射最高。
[Abstract]:Objective: to compare and evaluate the treatment of axillary osmidrosis by local injection of botulinum toxin A, small incision excision of sweat gland and minimally invasive suction under negative pressure, in terms of postoperative efficacy, postoperative complications, postoperative recurrence rate and so on. Methods: from April 2015 to June 2016, 92 patients with axillary osmidrosis were treated with botulinum toxin A (Botulinum toxin A) local injection and small incision large sweat gland excision. The patients were followed up for 6 to 9 months. The data of patients (age, sex, degree of axillary odor, etc.), postoperative efficacy, postoperative complications (such as bruising, hematoma, skin necrosis, incision rupture, etc.) were collected. Information on local infection, local numbness, scar contracture, postoperative recurrence rate, etc. Results the age, sex and severity of axillary osmidrosis were measured by x2 test among the three groups: group A, small incision hyperhidrosis group (group B) and minimally invasive negative pressure aspiration group (group C). The results showed that there was no significant difference in age, sex and axillary odor severity between the three groups, and the difference was not statistically significant among the three groups, and the curative effect of the three groups was analyzed statistically, and the difference between the three groups was not statistically significant, which indicated that there was no significant difference in age, sex and the severity of axillary osmidrosis among the three groups, and there was no significant difference between the three groups in terms of age, sex and the severity of axillary osmidrosis. The effective rate of the three methods was 100, no difference was found among the three methods. The curative effect of the three treatments was 87.5% and 92.3%, respectively, and the x2 test was carried out. There was no significant difference between the three methods. The curative effects of the three treatments for the severe axillary odor were 57.1and 84.6mg / kg, respectively. X2 test was performed with 19.54% (P0.01), and there was significant difference between the two groups (P < 0.05). There were significant differences between group A and group B (P 0.01) and group B and group C (P 0.01). There was no significant difference between group A and group C (P 0.05). The total incidence of complications in the three groups was 2.2 and 2510.9, respectively. There was significant statistical difference in the total incidence of complications between group A and group C. the total incidence of complications in group A and group B were examined by x2 test, and the total incidence of complications in group A and group B was 22.12 (P 0.01) and group B (P 0.01) respectively, and the total incidence of complications in group A was significantly higher than that in group C (P 0.01), and the total incidence of complications in group A was higher than that in group B (P 0.01). There was significant difference between group A and group C (P 0.05). The recurrence rate of the three groups within half a year was 78.9% and 10.5, respectively. There was a significant difference between the three groups by x2 test x 2175.50 (P0.01), and there was a significant difference between group A and group C (P 0.05), and the recurrence rate of the three groups within half a year was 78.9% and 10.5% respectively, and there was a significant difference between the three groups by x2 test (x2175.50, P0.01). The recurrence rates of group A and group B were examined by x2 test, respectively. There were significant differences between group A and group B and group C, respectively. Conclusion there was no significant difference among the three methods for mild and moderate axillary osmidrosis, as well as for group A and group C (P 0.01, P 0.01, P 0.01, P 0.01, respectively). Conclusion: there is no significant difference in the efficacy of the three methods in the treatment of mild and moderate axillary osmidrosis, and there is no significant difference between group A and group C in the treatment of axillary osmidrosis, and there is no significant difference between the three methods in the treatment of axillary odor. For severe axillary osmidrosis, small incision large sweat gland cutting is superior to the other two treatment methods .2.The incidence of complications is the highest in small incision large sweat gland cutting. The local injection rate of botulinum toxin A was the lowest in minimally invasive negative pressure aspiration. The recurrence rate was the lowest in small incision hyperhidrosis and the highest in minimally invasive negative pressure aspiration.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.741

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