目的：比较微创刮除术与大汗腺修剪术治疗腋臭的临床疗效及安全性。方法2011年3月至2012年3月，拟行手术治疗的腋臭患者114例共211侧，按照随机数字表分为两组，一组56例共104侧，采用微创大汗腺刮除术；另一组58例107侧，行小切口皮下大汗腺修剪术。平均随访1.4年，比较两组术后并发症发生率、切口加压包扎时间、疤痕长度及复发率差异。结果刮除术组术后并发症发生率低于修剪术组（4.8%vs.12.1%，χ2=4.409， P=0.035），复发率高于修剪术组（12.5%vs.3.7%，χ2=5.465， P=0.019）；刮除术组加压包扎时间、疤痕长度均低于修剪术组[(2.8±0.2）天 vs.(7.1±0.5）天， t=82.436， P<0.001；（1.0±0.4）cm vs.（4.3±0.9） cm， t=34.577， P<0.001]。结论微创刮除术术后并发症少，而大汗腺修剪术术后复发率低，两种手术治疗腋臭均安全有效。%Objective To compare the clinical efficacy and safety of micro-invasive curettage and apocrine sweat gland pruning for the treat-ment of osmidrosis. Methods 211 sides of 114 patients with osmidrosis from Mar. 2011 to Mar. 2012 were randomly divided into two groups , a group of 56 cases with a total of 104 side were treated with micro-invasive curettage; another group of 58 cases with a total of 107 sides were treated with small incision subcutaneous apocrine pruning. The average follow up period was 1.4 years, the differences of postoperative complication rate, time, length of incision of pressurized bandaging scar and recurrence rate between two groups was compared. Results The postoperative complica-tion rate in curettage group was lower than that in pruning group (4.8%vs.12.1%,χ2=4.409, P=0.035), and the recurrence rate was higher than that of pruning group (12.5%vs. 3.7%,χ2=5.465, P=0.019). The pressure dressing time, scar length in curettage group were lower than those in pruning group ((2.8±0.2)d vs. (7.1±0.5)d, t=82.436, P<0.001; (1.0±0.4)cm vs.(4.3±0.9) cm, t=34.577, P<0.001). Conclusion The micro-invasive curettage has fewer postoperative complications, but the apocrine sweat gland pruning has lower recurrence rate. Both of two kinds of operation treat-ment for the treatment of osmidrosis are safe and effective.
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