改良腋臭根治术治疗前后患者的生活质量分析

Analysis of the quality of life of patients before and after modified radical axillary surgery

目的:讨论顺腋纹平行双切口保留真皮血管网切除大汗腺术治疗腋臭及对患者生活质量的影响。方法:选择2013年6月—2017年3月在我科门诊接受腋臭微创手术的119例患者(男52例,女67例),年龄16~62岁,采用腋臭程度分级标准来评估疾病的严重程度,选用高汗症疾病严重性量表(HDSS)来评估排汗程度,并采用改良后的皮肤病生活质量指数(DLQI)来评估生活质量。结果:在经顺腋纹平行双切口保留真皮血管网切除大汗腺手术后,患者的病情明显减轻,生活质量有了明显改善,总的DLQI分数比基础值低得多(P<0.0001),排汗情况在治疗后改善显著(P<0.0001)。另外,在性别上,治疗前的生活质量评分和排汗情况量表有着显著不同(P<0.05)。结论:顺腋纹平行双切口保留真皮血管网切除大汗腺治疗能够减轻疾病的严重程度、缓解排汗情况和改善患者的生活质量。同时,这种术式的创伤小,易操作,恢复快,并发症发生率低,瘢痕细小,腋窝外观和功能良好,作用时间持久。

Objective:To evaluate the quality of life of bromhidrosis patients after receiving apocrine sweat gland excision by parallel axillary incision with dermal vascular network maintained.Methods:A total of 119 patients(62 females and 57 males)between 18 and 65 years suffering from moderate to severe bromhidrosis were treated with minimally invasive surgery from June 2013 to March 2017 in my department.The armpit odor rating scale was used to assess the severity of the disease.The hyperhidrosis disease severity scale(HDSS)was chosen to evaluate the elimination of sweating and the modified Dermatology Life Quality Index was used(DLQI)to assess the quality of life.Results:After the minimally invasive surgery,the patients’quality of life was improved significantly,and the total DLQI score was much lower than the base value(P<0.0001).Sweating was significantly decreased after the treatment(P<0.0001).In addition,there was a notable difference in the pretreatment DLQI and HDSS scores between the two sexes(P<0.05).Conclusion:Parallel double incision of the axillary vein,in which the apocrine gland is removed and the dermal vascular network retains,can reduce the severity of the disease,decrease sweating and improve the patient’s quality of life.The operation is less traumatic and easy to operate,which ensures quick recovery,a low complication rate,small scars,good axillary appearance and functions,and a lasting effect.