单切口腋下顶泌汗腺切除术治疗未成年与成年臭汗症患者效果比较

Efficacy of one-incision remoual of axillary apocrine glands in children and adult patients with axillary osmidrosis: a comparative analysis

目的探讨单切口腋下顶泌汗腺切除术治疗未成年与成年臭汗症患者的安全性及效果。方法2013年1月至2016年12月,北京大学第一医院整形烧伤外科同一医师用同一术式治疗初发臭汗症患者164例,男54例、女110例,年龄8~61岁,中位年龄22岁。将患者分为未成年组31例和成年组133例,比较两组手术后效果并随访。结果截止到2019年12月,164例患者术后3年治愈率、总满意率分别为77.6%(125/161)、88.2%(142/161);其中未成年人组分别为87.5%(27/31)、93.5%(29/31)。随访期内,两组患者的治愈率、瘢痕满意率、色素沉着满意率、总满意率差异均无统计学意义(均P>0.05),未成年组患儿成年后治愈率、显效率、总满意率分别为80.0%(20/25)、92.0%(23/25)、96.0%(24/25)。结论对于有症状的未成年臭汗症患儿可采取单切口腋下顶泌汗腺切除术,该术式安全、有效,且效果持久,值得临床应用。

Objective To evaluate the safety and efficacy of single incision apocrine gland excision in the treatment of children and adult patients with axillary osmidrosis.Methods Medical records and follow-up results were reviewed for 164 patients who underwent surgical treatment in our department by the same surgeon from January 2013 to December 2016.There were 54 males and 110 females,aged 8-61 years.with a median age of 22 years.The patients were divided into the children group(n=31)and the adults group(n=133),and differences between the two groups were compared.Results The end point of follow-up was December 2019,the cure and overall satisfaction rates in the third year after surgery were 77.6%(125/161)and 88.2%(142/161)for the total population,including 87.5%(27/31)and 93.5%(29/31)for the children,respectively.There were no significantly differences in the cure rate,scar,pigmentation and the patients'satisfaction between two groups during the follow-up.The cure rate,significantly improved rate and satisfaction rate in patients who became adult during the follow-up were 80.0%(20/25),92.0%(23/25)and 96.0%(24/25),respectively.Conclusions Single incision apocrine gland excision could be performed for children patients.Our procedure is safe,reliable and consistant,and worthy of clinical application.