肿胀麻醉吸刮修剪法治疗腋臭的临床疗效分析

发布时间：2018-04-30 13:55

本文选题：腋臭 + 大汗腺　；参考：《第四军医大学》2010年硕士论文

【摘要】：腋臭是一种常见病,一般认为与大汗腺分泌功能异常有关。随着人们生活水平的提高和社交活动的增多,腋臭已经成为患者的严重心理负担,影响正常的生活和工作。目前国内外治疗腋臭的方法众多,但大都因为对腋臭的发生机制或对大汗腺的分布不明确而难以达到理想的治疗效果。我们在查阅大量文献的基础上,对腋臭的发病机制、大汗腺的分布范围做了全面的了解,对以往的治疗方法进行了全面的分析,总结了以往腋臭治疗方法的优缺点,设计了一种新的治疗腋臭的手术方法:肿胀麻醉吸刮修剪法治疗腋臭。临床应用87例,对临床疗效进行观察分析,并对20例汉族腋臭患者大汗腺的分布进行了验证性检测。目的:通过对汉族腋臭患者大汗腺的分布范围的验证性检测,探索能够比较彻底的祛除腋臭患者大汗腺,术后外观、功能良好的治疗腋臭的手术方法,并进行临床应用。方法:对我科2007年9月至2009年10月期间前来就诊的87例腋臭患者,使用顺腋皱襞切口肿胀麻醉吸刮修剪法治疗,对其中20例患者腋部不同部位的皮肤和皮下组织进行组织学检测,检查腋臭患者大汗腺的分布情况。经过随访,观察临床疗效。结果:20例汉族腋臭患者大汗腺分布的广度和层次与腋毛毛囊的分布基本相似但有差别,分布层次主要在真皮网状层和浅层脂肪层,分布范围约至腋毛边缘1.0cm处;87例使用肿胀麻醉吸刮修剪法治疗的腋臭患者随访3-12个月,痊愈86例,好转1例,总有效率100%,早期并发症发生率8.0%,其中皮下血肿3例(3.4%),皮肤部分坏死2例(2.3%),切口延期愈合2例(2.3%);后期并发症发生率1.1%:臭味复发1例(1.1%)。结论:汉族腋臭患者大汗腺分布层次主要在真皮网状层和浅层脂肪层,范围主要在腋毛生长区及腋毛生长区外1.0cm范围内。肿胀麻醉吸刮修剪法治疗腋臭能够比较彻底的祛除大汗腺,是一种效果确切、治愈率高、并发症少、对患者上肢功能和腋部外观影响小的手术方法,值得推广使用。
[Abstract]:Axillary odor is a common disease, generally considered to be associated with abnormal secretion of sweat glands. With the improvement of people's living standard and the increase of social activities, axillary odor has become a serious psychological burden for patients, affecting normal life and work. There are many ways to treat axillary odor at home and abroad, but it is difficult to achieve the ideal therapeutic effect because of the unclear mechanism of axillary smelly or the distribution of sweat gland. On the basis of consulting a large number of literatures, we have made a comprehensive understanding of the pathogenesis of axillary odor and the distribution of hypersweat glands. We have made a comprehensive analysis of the previous treatment methods and summarized the advantages and disadvantages of the previous treatment methods. A new operative method for the treatment of axillary smelly was designed: swelling anesthesia, suction, curettage and pruning. 87 cases of clinical application were observed and analyzed, and the distribution of large sweat glands in 20 patients with axillary osmidrosis in Han nationality was examined by confirmatory test. Objective: to detect the distribution of hyperhidrosis glands in patients with axillary odor in Han nationality, and to explore the operative method of removing the hypersweat glands completely and treating axillary smelly with good function after operation, and to carry on the clinical application. Methods: 87 patients with axillary osmidrosis from September 2007 to October 2009 were treated with swelling anesthesia and curettage through axillary fold incision. Histopathological examination was performed on the skin and subcutaneous tissue of 20 patients with axillary osmidrosis. The clinical effect was observed after follow-up. Results the distribution of hypersweat glands in 20 patients with axillary odor was similar to that in the axillary hair follicles. The distribution levels were mainly in the dermis reticular layer and the superficial fat layer. 87 patients with axillary osmidrosis treated by swelling anesthesia suction and pruning were followed up for 3 to 12 months. 86 cases were cured and 1 case improved. The total effective rate was 100, and the incidence of early complications was 8.0. 3 cases had subcutaneous hematoma, 2 cases had partial necrosis of skin, 2 cases had delayed healing of incision and 2 cases had delayed healing. Conclusion: the distribution of hypersweat glands in patients with axillary osmidrosis in Han nationality is mainly in the dermis reticular layer and superficial adipose layer, and mainly in the axillary hair growth area and 1.0cm outside the axillary hair growth area. The swelling-anesthetic curettage and pruning method can remove the hyperhidrosis completely. It is an effective method with high cure rate and less complications. It has little influence on the function of the upper limb and the appearance of the armpit. It is worth popularizing and using.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.741

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