不同切口大汗腺剪除术在重度腋臭患者微创根治术中的应用

Application of Different Incision Apocrine Sweat Gland Excision in Minimally Invasive Radical Surgery in Patients with Severe Axillary Osmidrosis

目的:探讨不同切口大汗腺剪除术在重度腋臭(axillary osmidrosis,AO)患者微创根治术中的应用效果。方法:选取2019年1月-2021年5月荆州市第二人民医院收治的74例欲行微创根治术的重度AO患者为观察对象。按随机数字表法将其分为双小切口组和单小切口组,各37例。双小切口组给予平行双小切口大汗腺剪除术,单小切口组给予单小切口大汗腺剪除术。比较两组围手术期指标、术后1个月临床疗效、术后随访期间并发症、治疗满意度及随访4~6个月复发情况。结果:双小切口组手术时间明显长于单小切口组(P<0.05),术后恢复时间明显短于单小切口组(P<0.05)。术后1个月,双小切口组总有效率(97.30%)明显高于单小切口组(83.78%)(P<0.05)。双小切口组瘢痕满意程度和术后异味评分均明显高于单小切口组(P<0.05)。随访期间,双小切口组术后并发症发生率(8.11%)明显低于单小切口组(27.03%)。术后4~6个月随访,两组复发率比较差异无统计学意义(P>0.05)。结论:与单小切口大汗腺剪除术相比,腋皱襞平行双小切口大汗腺剪除术在重度AO患者微创根治术中具有较高临床疗效,术后并发症更低,能有效促进患者术后恢复,且不易复发,患者满意度更高,具有较高的推广应用价值。

Objective:To explore the application effects of different incision apocrine sweat gland excision in the minimally invasive radical surgery in patients with severe axillary osmidrosis (AO).Method:A total of 74 patients with severe AO admitted to the Second People’s Hospital of Jingzhou from January 2019 to May 2021 were selected as the observation objects.According to the random number table method,the patients were divided the double small incision group and single small incision group,37 cases in each group.The double small incision group was given parallel double small incision apocrine sweat gland excision,and the single small incision group was given single small incision apocrine sweat gland excision.The perioperative indicators,clinical efficacy 1 month after operation,complications during postoperative follow-up,treatment satisfaction and recurrence condition 4-6 months of follow-up were compared in the two groups.Result:The operation time in the double small incision group was significantly longer than that in the single small incision group (P<0.05),and the postoperative recovery time was significantly shorter than that in the single small incision group (P<0.05).One month after operation,the total effective rate of double small incision group (97.30%) was significantly higher than that of single small incision group (83.78%) (P<0.05).The scar satisfaction and postoperative odor scores in the double small incision group were significantly higher than those in the single small incision group (P<0.05).During the follow-up period,the incidence of postoperative complications in the double small incision group (8.11%) was significantly lower than that in the single small incision group (27.03%).There was no significant difference in the recurrence rate between the two groups 4-6 months follow-up after operation (P>0.05).Conclusion:Compared with single small incision apocrine sweat gland excision,axillary fold parallel double small incision apocrine sweat gland excision has higher clinical efficacy and lower postoperative complications in minimally invasive radical surgery for patients with severe AO.It can effectively promote the postoperative recovery of patients,and it is not easy to relapse,has higher patients’ satisfaction,and has higher promotion and application value.