梭形切除Z成形手术与激光治疗腋臭疗效及并发症比较

Comparison of the Curative Effect and Complications between Z-plasty with Fusiform Excision and Laser in Treating Bromhidrosis

目的探讨梭形切除Z成形手术与激光治疗腋臭的效果和并发症。方法A组(梭形切除Z成形术)54例,即顺腋毛区梭形切除皮肤、皮下组织,切口做一小Z瓣缝合。B组(激光治疗)51例,即用激光直接烧灼腋毛区大汗腺。结果(1)疗效:A组术后气味完全消除50例,气味明显减轻4例,回访6个月～5年,无复发,疗效确切。B组术后气味完全消除23例,气味明显减轻28例,3～6个月后22例气味不同程度复发;(2)并发症:A组术后切口二期愈合1例,术后明显线形瘢痕2例,余无明显瘢痕,且无不适。B组术后伤口二期或三期愈合16例,术后局部硬块状瘢痕18例,且腋下不适。结论腋臭梭形切除Z成形术效果确切,并发症发生率低,与激光治疗比较,疗效及并发症差异有显著性(P<0.05),A组手术方式是治疗腋臭尤其是气味较重者的最佳选择。

Objective To discuss the curative effect and complications between Z - plasty with fusiform excision and laser in treating bromhidrosis. Methods For 54 cases in Group A （ Z - plasty with fusiform excision ） , fusiform excision of the skin and subcutaneous tissue in hircus area was made, and a small Z -flap suture of the incision was made then; for 51 eases in Group B （laser） , laser cauterization was made directly on apocrine gland of hircus area. Result 50 cases in Group A had complete elimination of the odor and the odor in the left 4 cases became much weaker, the follow - up for 6 months to 5 years showed no reoccurrence ; 23 eases in Group B had complete elimination of odor and the odor became much weaker in 28 cases, the follow - up for 6 months showed reoccurrence of the odor at certain degree in 22 cases ; Except for leases with secondary healing and 2 eases with obvious linear sears, the other had no obvious scars nor discomfort; 16 cases in Group B had secondary or third healing and 18 eases massive hard scars with discomfort in armpit. Conclusions Z - plasty with fusi- form excision is of definite curative effect for bromhidrosis with low occurrence of complications ; it is of significant difference in curative effect and complications from the laser treatment （ P 〈 0.05） ; z - plasty with fusiform excision is the best choice for patients with bromhidrosis, especially for those with strong odor.