毛囊单位提取技术治疗腋臭临床疗效分析

The effectiveness of follicular unit extraction used in the treatment of bromhidrosis

目的 评估毛囊单位提取技术(follicular unit extraction,FUE)与传统腋臭手术在腋臭治疗中的临床应用效果。方法 回顾性分析自2020年5月至2021年11月,联勤保障部队第九八〇医院烧伤整形科收治的73例(146侧)腋臭患者的临床资料。根据其治疗方法分为FUE治疗组(32例)和传统手术组(41例)。FUE治疗组采用内径1.0 mm的环钻顺毛囊单位方向提取腋毛及顶泌汗腺;传统手术组根据腋毛范围做1、2个顺皮纹方向3 cm切口,翻转皮瓣,去除顶泌汗腺。FUE治疗组记录毛囊单位提取数量、毛囊截断率,同时比较两组的手术效果、术后并发症、患者满意度和腋窝排汗改善效果。采用视觉模拟量表(visual analogue scale,VAS)评价腋臭治疗效果。随访6~12个月。结果 FUE治疗组除1例左侧腋窝出现局部炎性丘疹外,其他患者无任何不适;传统手术组2侧腋窝出现皮肤部分坏死,7侧腋窝遗留明显瘢痕。两组均未见复发病例,治疗后两组VAS评分为0~4分。两组手术效果评估、患者满意度、腋窝排汗改善效果差异均无统计学意义(P>0.05)。结论 FUE技术微创治疗腋臭,疗效确切,同时患者耐受性较好,术后并发症较少,值得临床推广。

Objective To introduce the application of follicular unit extraction(FUE)in bromhidrosis treatment and to evaluate the effects of FUE and traditional approach.Methods The clinical data of 73 patients with bromhidrosis in Department of Burn and Plastic Surgery of the 980th Hospital of the Joint Logistic Support Force of PLA from May 2020 to November 2021 was retrospective analysis.According to the therapeutic methods,they were divided into FUE group(32 patients)and traditional group(41 patients).For FUE group,the axillary follicular units and apocrine sweat glands were collected via a trephine drill with an inner diameter of 1.0 mm.For traditional group,according to the range of axillary hair,one or two 3 cm long parallel incisions were made transversely.The skin flap was turned over and apocrine sweat glands were removed.The number of extracted follicular units,hair follicle truncation rate were recorded in FUE group.Surgical effect,postoperative complications,postoperative satisfaction and improvement of axillary sweat were collected and compared.A 10-point visual analog scale was used to evaluate the effectiveness of bromhidrosis.All patients were followed up for 6 to 12 months.ResultsExcept for one case with local inflammatory papules in the left armpit,the rest of the FUE group patients had no discomfort,while necrosis occurred in 2 sides,and 7 sides formed scars of axillae in traditional group.No recurrence occurred in both groups.Both groups showed similar odor levels varied between O and 4.There was no significant difference between the two groups in the evaluation of surgical effect,patients'satisfaction,improvement of axillary sweat(P>0.05).Conclusion The minimally invasive treatment of bromhidrosis by FUE is effective,well tolerated by patients,and has few postoperative complications.Overall,FUE has broad clinical prospects and is worthy of medical promotion.