化脓性汗腺炎外科治疗研究进展

Advances in surgical treatment of hidradenitis suppurative

化脓性汗腺炎具有慢性、难治性、复发性的特点,其治疗应在内科治疗的基础上有针对性地联合外科干预。目前,应用于临床的外科治疗方式包括切开引流术、去顶术、激光治疗、强脉冲光治疗、光动力疗法等局部治疗,以及保留皮肤组织的电切剥离术、扩大切除术等完整的病损切除治疗。各种治疗方式的清除范围、治疗效果、术后并发症及复发风险各不相同。其中,局部治疗对患者的损伤较小,但复发率高,主要适用于轻中度患者;病损切除治疗复发率较低,但手术损伤大、术后涉及创面重建,主要适用于中重度患者。本文综述了化脓性汗腺炎的外科治疗原则及各种外科治疗方式,以期为该病的规范诊治提供参考。

Hidradenitis suppurative is a chronic,refractory and recurrent dermatological disease.The disease should be managed by targeted surgical intervention on the basis of medical treatment.Currently,the surgical treatment methods include local treatments like incision and drainage,unroofing,laser therapy,intense pulsed light therapy,photodynamic therapy,as well as complete lesion resection such as skin-tissue saving excision with electrosurgical peeling and extended excision.The clearance range,therapeutic effect,postoperative complications,and recurrence risk vary among the different treatment methods.Local treatments cause less damage,but have high recurrence rates,and are mainly for mild to moderate hidradenitis suppurative patients.Complete lesion resections have relatively low recurrence rates,but may bring more surgical injuries,and postoperative reconstructions are needed,which are mainly for moderate to severe hidradenitis suppurative patients.In this article,the surgical treatment principles and various surgical treatment methods of hidradenitis suppurative are reviewed,to provide a reference for the diagnosis and treatment of this disease in clinical practice.