摘要：
Objective To investigate the efficiency of a combined surgical procedure with tumescent suction, blind scraping in the subcutaneous adipose tissue layer, direct excision of apocrine sweat glands and the electric scraping spoon sequentially burns the stationary folliculus to treat axillary osmidrosis. Methods A total of 1 066 patients of axillary osmidrosis treated by comprehensive and minimally invasive surgical procedure in our hospital from January 2006 to December 2016. A long about 0.5-1.0cm small incision was performed in the ulnar side next to axilla. An assisted incision(1cm) was performed in the center of the axilla area. Liposuction was performed in the superficial subcutaneous fat layer. Skin at the marked region was everted and curettage with direct pruning technique. Sweat glands along with remaining fat tissue were removed by scissors, and the electric scraping spoon sequentially burns the stationary folliculus. Compressive dressings were applied to the axilla area after the operation. Results Followed up for 6-12 months, among 1 066 patients, 913 cases were markedly effective, 142 cases were effective and 11 cases were invalid. The effective rate was 98.97%. Hematoma occurred in 23 cases, skin necrosis occurred in 5 cases, and the wound healed after skin grafting. Conclusion Our comprehensive surgical procedure with tumescent suction, blind scraping in the subcutaneous adipose tissue layer and direct excision of apocrine sweat glands, and the electric scraping spoon sequentially burns the stationary folliculus can effectively cure axillary osmidrosis, is a safe and effective surgical treatment with less complication.%目的:探讨联合负压抽吸、小切口直视皮下修剪及电刮勺热灼的综合性微创方法治疗腋臭的临床疗效.方法:2006年1月-2016年12月笔者科室采用微创综合疗法治疗腋臭1066例,沿腋窝尺侧腋皱襞附近作一长约0.5~1.0cm小切口,在腋窝中央作一长约1cm辅助切口.沿手术切口负压抽吸浅层脂肪,在直视下修剪皮下残余脂肪组织及真皮网状层的毛囊球,电刮勺依次在皮下烧灼静止期毛囊,术后打包加压包扎7d.结果:本组共1066例患者,随访6~12个月,显效913例,有效142例,无效11例,有效率为98.97%.术后血肿23例,5例发生皮片坏死,植皮后创面愈合,其余均通过换药治愈.结论:联合负压抽吸、小切口直视皮下修剪及电刮勺热灼的综合方法能有效根治腋臭,具有安全、高效、术后并发症少等优点.
