负压抽吸联合搔刮术与腋皱襞小切口皮下修剪术治疗腋臭的疗效比较

Study on negative pressure suction combined with scratching and axillary fold micro-incision subcutaneous trimming in the treatment of bromhidrosis and its effect on incision scars and complications

目的 比较负压抽吸联合搔刮术与腋皱襞小切口皮下修剪术对腋臭的治疗效果,探讨切口瘢痕增生及术后并发症发生率。方法 136例腋臭患者分为负压联合搔刮组(n=63,采用负压抽吸联合搔刮术治疗)及皮下修剪组73例(n=73,采用腋皱襞小切口皮下修剪术治疗),比较2组患者的治疗效果、术后切口瘢痕增生率、手术时间、住院时间、伤口拆线时间、疼痛(VAS)评分、生活质量(SF-36)评分及并发症发生率(血肿、皮下积液、异味残留、伤口感染)。结果 皮下修剪组患者治疗总有效率高于负压联合搔刮组,术后第1天的疼痛VAS评分高于负压联合搔刮组,手术时间、住院时间及伤口拆线时间均长于负压联合搔刮组,术后6月活力、躯体角色、社会功能、健康状况的SF-36评分高于负压联合搔刮组,术后并发症发生率低于负压联合搔刮组,差异有统计学意义(P <0.05);2组患者术后瘢痕增生发生率比较,差异无统计学意义(P> 0.05)。结论 腋皱襞小切口皮下修剪术对腋臭的治疗效果优于负压抽吸联合搔刮术,前者切口瘢痕增生不明显,可降低并发症并提升患者生活质量。

Objective To investigate the efficacy of negative pressure suction combined with scratching and axillary fold micro-incision subcutaneous trimming in the treatment of patients with bromhidrosis and its influence on incision scars and complications.Methods One hundred and thirty-six patients with bromhidrosis were divided into negative pressure suction combined with scratching group(63 cases,receiving negative pressure suction combined with scratching treatment)and subcutaneous trimming group(73 cases,receiving axillary fold micro-incision subcutaneous trimming treatment).The clinical efficacy,hyperplasia rate of postoperative incision scars,incidence rates of postoperative complications(hematoma,subcutaneous exudate,residual odor,and wound infection),operation time,hospital stay,wound stitches removal time,pain visual analogue scale(VAS),and quality of life(SF-36)score were compared between both groups.Results The overall effective rate of subcutaneous trimming group was higher than that of scratching group;the VAS score of pain in subcutaneous trimming group 1 day after operation was higher than that of scratching group.The operation time,hospital stay and wound suture removal time in subcutaneous trimming group were longer than those of scratching group;incidence rate of post-operative complications was also lower than that of scratching group,differences were statistically significant(P<0.05).There was no significant difference in the incidence rate of post-operative scar hyperplasia between both groups(P>0.05).Conclusion The clinical efficacy of axillary fold micro-incision subcutaneous trimming in the treatment of bromhidrosis is better than negative pressure suction combined with scratching.The incision scar hyperplasia is not obvious,which can reduce the incidence of complications and improve patients'quality of life.