基于病理定位的腋窝横皱襞切口大汗腺修剪根治腋臭

Surgical management of bromidrosis based on pathogenesis through axillary fold incision

目的探讨有效治疗腋臭症的一种方法及其病理基础。方法对18例腋臭症标本进行常规病理观查,明确汗腺定位,并以此为据指导手术。对81例患者进行了治疗,并对并发症进行了分析。结果病理显示所有病例均检测到大汗腺,其数量个体差异较大。大汗腺多位于毛囊乳头深层皮下组织层,少部分位于毛囊乳头以浅,并深入到真皮网状层。根据解剖定位,以毛囊为一相对定位标志,毛囊以深脂肪组织全修剪,毛乳头一并去除。浅层脂肪及毛囊修剪完毕后,真皮网状层部分突出结缔组织一并修剪。术后多数患者疗效满意,切口瘢痕不明显。结论采用腋窝横皱襞切口,基于汗腺病理定位的大汗腺修剪根治腋臭术式是一有效方法。不但切口细小,且可同时脱毛,对女性尤其适用。

Objective To investigate the surgical management of bromidrosis based on pathogenesis.Methods Eighteen tissues of bromidrosis were investigated by pathogenesis processure.81 patientes were managed by apocrine gland excision through axillary fold incision.Complicationes were analyzed.Results Apocrine gland was positioned mostly in the subcutaneous undermined the hair follicles,partly in the reticular layer of dermis.Satisfactory results were received by the tissue excision both apocrine gland in the subcutaneous and reticular layer of dermis.sixty two cases of 81 patientes were followed up 3 months to 24 months.Fixty four patientes experienced no odor postoperatively,8 patientes experienced very mild axillary odor in one axillary fossa postoperatively.Scar formation was nonvisible.Complications among 81 patientes including 11hematomas,almost all hairless axilla or a marked decrease of axillary hair,and a decrease in axillary sweat.Conclusions The method achieves almost complete excision of the apocrine gland and provides excellent functional and cosmetic results