小切口大汗腺清除术治疗腋臭的并发症分析

发布时间：2018-11-22 20:01

【摘要】： 目的：分析小切口大汗腺清除术治疗腋臭的手术方法产生并发症的原因和临床表现,探讨预防措施及其并发症的处理方法,以减少其不良并发症,提高治疗效果。方法：对本科内2007年4月～2010年4月期间226例行腋窝皮肤皱褶小切口大汗腺清除手术的腋臭患者术后出现的各种并发症(包括血肿、皮下积液、血清肿、切口延迟愈合、表皮坏死、切口缘皮肤全层坏死、切口内翻、假性皮脂腺囊肿、腋下皮肤不平整、上肢功能障碍、腋下瘢痕增生、腋区异味复发)进行分析和总结,以采取有效的措施进行预防和治疗,提高手术效果。结果：226例患者均采用腋窝皮肤皱褶小切口大汗腺清除术,术后随访2个月至3年。190例患者切口一期愈合,异味消失。其余36例伴有并发症,其中血肿11例,皮下积液3例,血清肿1例,切口延迟愈合5例,表皮坏死1例,切口缘皮肤全层坏死1例,切口内翻2例,假性皮脂腺囊肿1例,腋下瘢痕增生5例,采取相应的治疗措施后,并发症消失。腋下皮肤不平整3例,上肢功能障碍1例,未经处理,3-6个月后自行恢复。复发2例,再次行手术治疗后异味消失。结论：目前常用的腋臭治疗方法包括药物外涂,药物局部注射,激光治疗以及手术治疗。小切口大汗腺清除手术治疗腋臭的手术方法清除汗腺比较彻底,切口隐蔽,复发率低,是目前最常用的手术方式,但是手术处理不当会出现一些并发症,影响了手术效果。通过完善的术前准备,规范的手术操作及恰当的术后处理,大部分并发症是可以避免和控制的。
[Abstract]:Objective: to analyze the causes and clinical manifestations of complications in the treatment of axillary odor by small incision excision of sweat glands, and to explore the preventive measures and the management of complications in order to reduce the adverse complications and improve the therapeutic effect. Methods: all kinds of complications (including hematoma, subcutaneous effusion, serumatosis, incision delayed healing) occurred in 226 patients with axillary osmidrosis treated with axillary skin crease small incision during April 2007 to April 2010. Epidermal necrosis, full-thickness necrosis of incision margin, incision varus, pseudosebaceous gland cyst, axillary skin unevenness, upper limb dysfunction, axillary scar hyperplasia, axillary region odor recurrence) were analyzed and summarized. To take effective measures to prevent and treat, improve the results of surgery. Results: 226 patients were treated with axillary skin crinkle small incision big sweat gland clearance, followed up for 2 months to 3 years. 190 cases of incision healing, the smell disappeared. The other 36 cases had complications, including hematoma in 11 cases, subcutaneous effusion in 3 cases, serum swelling in 1 case, delayed healing in 5 cases, epidermal necrosis in 1 case, full-layer necrosis of incision edge in 1 case, incision varus in 2 cases, pseudosebaceous cyst in 1 case. There were 5 cases of axillary scar hyperplasia. The complications disappeared after the corresponding treatment. Axillary skin unevenness in 3 cases, upper limb dysfunction in 1 case, untreated, 3-6 months after self-recovery. Recurrence occurred in 2 cases, and the odour disappeared after reoperation. Conclusion: the commonly used methods of axillary osmidrosis treatment include drug application, drug injection, laser therapy and surgical treatment. The surgical method of removing sweat gland through small incision is more thorough, the incision is hidden and the recurrence rate is low, so it is the most commonly used operation method at present, but some complications will appear when the operation is improperly handled, which affects the effect of the operation. Most complications can be avoided and controlled by improved preoperative preparation, standardized operation and proper postoperative management.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.741

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