几种不同术式超薄皮瓣法腋臭小切口根治术的比较研究

Comparison of several surgical styles of minimally invasive operation for axillary osmidrosis

目的:探讨不同超薄皮瓣术式和包扎方式根治腋臭的临床疗效及对并发症的影响。方法:对124例病人245侧腋臭采用3种不同的切口及包扎方式,比较临床疗效和近、远期并发症的发生率。切口术式包括双侧"W"形切口、下缘单侧"W"形切口和腋窝中部皱襞线纵切口;包扎方式包括"六点式"缝线包扎法、多开孔式橡皮条引流包扎法和"铆钉式"皮肤固定加压包扎法。结果:不同切口术式或包扎方式临床疗效之间比较无统计意义(P>0.05)。术后近期并发症发生率为17.14%;远期并发症发生率为14.29%。其中,双侧"W"形切口的近期或远期并发症均低于其余两种切口方式(P<0.05);多开孔式橡皮引流条打包法的近期并发症发生率低于其余两种包扎方式(P<0.05),远期并发症无显著差别(P>0.05)。未能证实不同切口和包扎方式对近期或远期并发症的影响具有交互作用。结论:3种不同切口方式及不同包扎方式对临床疗效无影响。但双侧"W"形切口有助于降低患者的近期和远期并发症;多开孔式橡皮引流条打包法有助于降低近期并发症,但对远期并发症无影响。

Objective：To investigate the efficacy of different incising and dressing styles of minimally invasive surgery for axillary osmidrosis and their effects on complications.Methods：Totally 124 patients with axillary osmidmsis（245 sides）undergoing different minimally invasive surgeries were analyzed and were randomly divided into three groups.Three incising styles of and three dressing styles were performed on patients in the three groups respectively and clinical efficacy as well as short and long term complication incidences were compared.Incising styles included bilateral ‘W’shape incision,unilaterally ‘W’shape incision on the inferior border and vertical incision through the axilla center.The dressing styles included ‘six points’suturing dressing,multi-poles rubber drainage dressing and ‘rivet-type’fixing and compressing dressing.Results：Axillary sweating and hair growth were reduced in all patients.No statistical significance in clinical efficacy was observed among different styles of incising and dressing（P〉0.05）.Postoperative complication incidences were 17.14% in short term and 14.29% in long term.Postoperative complication incidences in short and long term were lower in bilateral ‘W’shape incision than in the other two incising styles（P〈0.05）.Postoperative complication incidence in short term was lower in multi-poles rubber drainage dressing than in the other two dressing styles（P〈0.05）,but no difference was observed in long term among the three styles（P〉0.05）.Interactive effects of different incising and dressing styles on short and long term complications were not verified.Conclusions：There was no significant difference in clinical efficacy among three incising and dressing styles.Bilateral ‘W’shape incision can reduce the short and long term complications and multi-poles rubber drainage dressing can reduce short term complication but has no effect on long term complication.