3种不同方式治疗腋臭的并发症发生率及美学效果比较

Comparison of the incidence and aesthetic effects of three different treatments for axillary osmidrosis

目的探讨A型肉毒毒素注射法、脂肪肿胀麻醉抽吸术、小切口皮瓣修剪术3种不同方式治疗腋臭的并发症发生率及美学效果。方法选取2017年1月至2018年1月昆明医科大学第二附属医院整形外科收治的确诊为腋臭的90例初次治疗患者作为研究对象,随机分为A、B、C 3组,每组各30例。A组给予A型肉毒毒素局部注射干预治疗,B组给予皮下脂肪肿胀麻醉抽吸术治疗,C组给予小切口皮瓣修剪术治疗。比较3种不同方式治疗腋臭的并发症(淤青伴血肿、皮片及皮缘坏死、脂肪液化、创面局部感染和瘢痕挛缩伴功能受限)发生率、美学效果(创面愈合情况、术后腋窝皮肤外观)及患者精神满意状况(抑郁和焦虑)。结果 C组腋臭并发症发生率最高,B组次之,A组最低;A组美学效果最好,B组次之,C组最差;汉密尔顿抑郁量表和汉密尔顿焦虑量表评估结果显示,3组治疗前后抑郁和焦虑水平均有影响,治疗后C组抑郁和焦虑水平最高,B组次之,A组最低,差异均有统计学意义(P<0.05)。结论相对于脂肪肿胀麻醉抽吸术和小切口皮瓣修剪术,A型肉毒毒素注射法在术后并发症发生率和美学效果、患者精神满意状况方面均更有优势,对腋臭患者治疗方式的选择有重要临床指导意义,值得临床推广应用。

Objective To investigate the incidence of complications in the treatment of axillary odour by three different methods of botulinum toxin A injection,fat swelling and curettage and small incision flap pruning.Methods A total of 90 patients with definite diagnosis of axillary odour admitted from January 2017 to January 2018 in the Second Affiliated Hospital of Kunming Medical University were randomly divided into A,B,C three groups with 30 people in each group.Group A was treated with local injection of botulinum toxin,group B with subcutaneous swelling anesthesia and aspiration,and group C with small incision skin flap pruning.By comparing the incidence of complications(bruising with hematoma,skin necrosis,lipid liquefaction,local wound infection and scar contracture with functional limitation)and aesthetic effect(wound healing,axillary skin appearance)of three different treatments for axillary osmidrosis,and the patients′mental satisfaction(depression and anxiety)was evaluated.Results For the incidence of complications in the treatment of axillary osmidrosis,group C was the highest,followed by group B,and group A was the lowest.Aesthetic effects of group A was the best,followed by group B and group C.The results of Hamilton Depression Scale and Hamilton Anxiety Scale showed there was an effect on the levels of depression and anxiety before and after treatment.After treatment,the levels of depression and anxiety in group C were the highest,followed by group B and group A,and the differences were statistically significant(P<0.05).Conclusion Compared with swelling anesthesia aspiration and small incision skin flap pruning,Botulinum Toxin A injection has more advantages in the incidence of complications,aesthetic effect and patients′mental satisfaction.It has important clinical guiding significance for the treatment of axillary odour patients and is worthy of clinical popularization and application.