不同手术方法治疗腋臭临床疗效分析

Comparative study on clinical efficacy of different surgical methods for axillary osmidrosis

目的观察不同手术术式治疗腋臭的临床疗效,探讨和寻求疗效最佳的手术方法。方法对我院2011年1月至2013年7月收治的200例腋臭患者的临床资料进行回顾性分析,观察不同手术方法的远期疗效。手术方法分为传统腋臭切除术、微创刮除术、射频笔触式电针烧灼术和改良式切刮术,对观察数据进行统计学分析。结果传统切除术80例,手术切口平均愈合时间为18.7 d,远期疗效治愈78例(97.5%),显效2例(2.5%)。微创刮除术60例中,切口平均愈合时间为8.6 d;远期疗效治愈3例(5.0%),显效8例(13.3%),好转16例(26.7%),弱效4例(6.7%),无效29例(48.3%)。射频笔触式电针烧灼术30例,显效5例(16.7%),好转8例(26.7%),无效17例(56.6%)。改良式切刮术30例,伤口平均愈合时间为9.8 d,远期疗效治愈28例(93.3%),显效2例(6.7%)。结论传统切除术疗效好,但是伤口瘢痕大,恢复期长;微创刮除术和射频笔触式电针烧灼术恢复快,但是复发率高;改良式刮除术吸收了传统和微创手术的优点,恢复快,疗效肯定,缺点是伤口瘢痕较大,但是总体疗效令人满意,可以作为治疗腋臭的首选手术方法。

Objective To investigate the most appropriate surgical methods,different surgical modes of osmidrosis and their clinical effi-cacy were observed. Methods Clinical data was collected from 200 cases of axillary osmidrosis from January 2011 to July 2013. These cases were divided into four groups of the traditional group,minimally invasive group,RF pen-frequency electric cautery group and improved curet-tage group. Results The traditional group（80 cases） has an average healing period of 18. 7 days for operative incision including 78 cured cases（97. 5%）and 2 significant improved cases（2. 5%）. The minimally invasive group（60 cases）has an average healing time of 8. 6 days, among which there are 3 cured cases（5%）,8 significant improved cases（13. 3%）,16 improved cases（26. 7%）,4 cases（6. 7%）with weak curative effect and 29 failed cases（48. 3%）. In the RF pen-frequency electric cautery group（30 cases）,there are 5 significant improved ca-ses（16.7%）,8improvedcases（26.7%）and17failedcases（56.6%）.Theimprovedcurettagegroup（30cases）withanaverageincision healingtimeof9.8dayscontains28curedcases（93.3%）and2significantimprovedcases（6.7%）. Conclusion Thetraditionalgroup shows the best curative effect,nevertheless the incision needs a considerably amount of time to recover. The patients under the treatment of minimally invasive surgery or RF pen-frequency electric cautery can recover in short time but recrudescence always occur. The improved cu-rettage method,which is effective and safe,combines the advantages of traditional surgery and minimally invasive surgery. However,large scar left from this method still remains as its major disadvantage but the overall curative effect is satisfactory. The improved curettage is proved to be the most appropriate method for axillary osmidrosis.