顺腋纹平行双切口保留真皮血管网切除顶泌汗腺治疗腋臭

目的：评价肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术根治腋臭的疗效.方法：手术顺腋纹做两个平行切口,于腋浅筋膜浅层向四周锐性分离皮下组织达腋毛边缘,翻转皮瓣直视下逐一修剪顶泌汗腺组织.结果：本组68例共136侧,所有病例切口均I期愈合,无1例发生皮瓣坏死,术后经6～12个月的随访,治愈122侧,治愈率89.71%,显效14侧,显效率10.29%,总有效率100%.术后瘢痕轻微、隐蔽,腋窝皮肤活动性好,上肢功能无影响.结论：肿胀麻醉下顺腋纹平行双切口保留真皮血管网的顶泌汗腺切除术治疗腋臭总有效率高,并发症少,瘢痕小,为目前较理想的根治腋臭的手术治疗方法.     

直视下顶泌汗腺修除法治疗腋臭65例

我院自2001年以来,采用直视下顶泌汗腺修除法治疗腋臭65例,疗效满意,现报道如下： 1资料与方法 1．1临床资料 本组患者共65例,男性18例,女性47例,年龄18-47岁。其中有家族遗传史者51例。     

深浅两层顶泌汗腺处理法治疗腋臭术后并发症的分析和处理

目的分析探讨深浅两层顶泌汗腺处理法治疗腋臭,其术后并发症出现的原因和处理方法。方法对317例腋臭患者行深浅两层顶泌汗腺处理法治疗腋臭,观察术后并发症,分析原因并及时外科处理。结果 317例患者术后血肿20例(6.3%)、皮下积液12例(3.8%),皮肤瘀斑36例(11.4%),皮肤坏死5例(1.6%),切口裂开34例(10.7%),切口感染16例(5.1%),切口延期愈合71例(22.4%),切口瘢痕23例(7.3%),瘢痕挛缩12例(3.8%),异味残留11例(3.5%),腋毛脱落317例(100%);皮肤外科适当处理后效果满意。结论深浅两层顶泌汗腺处理法治疗腋臭术后并发症的发生与多种因素有关,及时恰当的处理仍可以获得满意的术后效果。     

单小切口与双小切口大汗腺修剪术治疗腋臭对比分析

 目的:对比分析单小切口与双小切口大汗腺修剪术治疗腋臭的疗效及并发症。方法：将111例患者随机分为A、B两组。A组(50例)行单小切口大汗腺修剪术,B组（61例）行双小切口大汗腺修剪术,比较两组治疗效果。结果：A、B两组总有效率均为100%。A组切口内侧表皮糜烂或裂开18例（36.00%）,B组切口内侧表皮糜烂或裂开11例（18.04%）,A组明显高于B组,差异有统计学意义（ X²=4.60,P<0.05）。结论：双小切口大汗腺修剪术术后并发症明显少于单小切口大汗腺修剪术。     

皮下修剪术治疗腋臭

皮下修剪术治疗腋臭赵亮罗公超吴余乐方方王强谭正辉陆明霞姚建军曹丹燕腋臭手术方法很多，我们在传统搔刮术基础上，通过改良，采用皮下修剪术，组织损伤小，术后局部反应轻，疗效肯定，美观性强。一、一般资料１９９４年８月至１９９５年６月门诊患者２６例，年龄１８～...     

小切口修剪术治疗腋臭

目的 探讨小切口顶泌汗腺非暴露修剪术治疗腋臭的可行性。 方法 对58例腋臭患者施行了小切口顶泌汗腺非暴露修剪术。 结果 随访1~12个月,除1例还有轻度异味外,其余57例治愈。每例（双侧）平均手术时间为55分钟。 结论 这是一种可广泛应用的、简便的、安全的、有良好效果的手术方式。     

腋臭患者腋区顶泌汗腺的分布特点

【摘要】 目的 检测腋臭患者腋区顶泌汗腺在深度、广度的分布,探讨其范围内的分布差异性。 方法 2010年9 - 12月间的15例腋臭患者,行直视下顶泌汗腺剪除术,切取切口处宽约2 mm的全层皮肤,深度达腋浅筋膜浅层,用于判明顶泌汗腺分布的深度。留取腋中心（点1）、距腋中心1 cm（点2）、距腋毛边缘内1 cm（点3）、腋毛边缘（点4）、距腋毛边缘外1 cm（点5）共5个标记点对应的皮下暗红色粗大的颗粒状组织,用于判明顶泌汗腺的分布范围及分布规律。 结果 顶泌汗腺分泌部主要分布于真皮网状层和皮下脂肪浅层,表皮层、真皮乳头层及腋浅筋膜浅层均无顶泌汗腺分布。顶泌汗腺广度分布与腋毛范围基本一致,腋中心部可见大量顶泌汗腺组织,腋毛边缘处仍有少量顶泌汗腺分布,腋毛边缘外1.0 cm处已无顶泌汗腺分布。5个点顶泌汗腺面积占整块组织面积的百分比平均值分别为74.1%、46.6%、25.3%、2.1%和0,相邻两点进行t检验,点1、2之间t = 29.78,P < 0.01;点2、3之间t = 9.76,P < 0.01;点3、4之间t = 20.83,P < 0.01;点4、5之间t = 1.96,P > 0.05。 结论 手术治疗腋臭时,清除范围深度达真皮网状层和浅层脂肪层,广度到腋毛范围即可,没有必要过度扩大清除范围。     

桥式双切口顶泌汗腺修剪术治疗腋臭176例临床分析

目的评价桥式双切口顶泌汗腺修剪术治疗腋臭的疗效及不良反应。方法采用桥式双切口顶泌汗腺修剪术治疗176例腋臭患者,用视觉模拟评分法(VAS)于术后1年评估其疗效及不良反应。结果 176例患者中,治愈164例(93%),有效12例(7%),总有效率100%。其中有4例患者切口发生表浅溃疡,延期愈合,留下轻微瘢痕。全组腋毛均减少,出汗减少,皮肤质地柔软,无感染、无血肿。结论桥式双切口顶泌汗腺修剪术操作方便,切口美观,不良反应少。     

小切口手术治疗腋臭的并发症分析

目的探讨如何减少小切口翻转皮瓣剃除术治疗腋臭的并发症。方法对19例出现并发症患者资料进行分析总结。结果皮瓣不同程度坏死9例、血肿和积液5例、切口感染、裂开3例、残留异味2例,可能与手术操作有关。结论小切口腋臭治疗术的并发症可能与皮瓣下组织剃除过多、切口缘反复夹持损伤、边角残留大汗腺、术后加压包扎不够有关。手术中应注意这些操作细节,减少并发症的发生。     

汗腺疾病

20120295深浅两层顶泌汗腺处理法治疗腋臭术后并发症的分析和处理/张斌(大连市皮肤病院外科),刘积东,张琪…//实用皮肤病学杂志.-2011,4(2).-99 ～101共治疗317例,其中男98例,女219例,年龄16～48岁.通过2 ～ 3cm皮肤小切口进入皮下,浅层剪除皮下脂肪及毛囊球,深层射频凝固脂肪内残余的腺体.术后随访半年.结果:一次治愈率为96.5％,有效率为100％.出现并发症87例(27.40％),包括血肿、皮下积液、皮肤瘀斑、皮肤坏死、切口裂开、感染、延期愈合、瘢痕、瘢痕挛缩、异味残留等.对其成因及预防处理,逐一进行了全面分析和探讨,经过正确处理后均达到了满意的效果.     

Innervation and receptor profiles of the human apocrine (epitrichial) sweat gland: routes for intervention in bromhidrosis

Background Human apocrine (epitrichial) sweat glands secrete in response to local or systemic administration of catecholamines and cholinergic agonists. As the process of secretion in human apocrine glands is not fully understood and no literature detailing the expression of adrenergic, cholinergic and purinergic receptors is available, there is a need to know the receptor types. Such data could provide new approaches for the treatment of axillary bromhidrosis. Objectives To investigate the localization of nerve fibres, adrenergic, cholinergic and purinergic receptors in human axillary apocrine sweat glands by immunohistochemistry. Methods Human axillary apocrine sweat glands were investigated by serial sectioning of paraffin wax‐embedded skin samples from volunteers. Sections were examined by light microscopy and immunohistochemistry, using antibodies against neurofilament, α‐ and β‐adrenoceptors, P2Y₁, P2Y₂ and P2Y₄ purinoceptors, and M₃ cholinoceptors. Results Neurofilaments were found near the eccrine but not the apocrine gland. Apocrine glands demonstrated the presence of β‐2 and β‐3 adrenoceptors in the secretory coil of the gland, but not α‐1, β‐1 or M₃ receptors. Glandular purinergic staining (P2Y₁, P2Y₂ and P2Y₄) was found in what looked like myoepithelial cells, while P2Y₁ and P2Y₂ staining was found on apical membranes and diffusely throughout secretory cells. Eccrine gland staining acted as internal positive controls. Conclusions No nerve fibres were found near the apocrine gland, suggesting that any catecholamine influence is through humoral effects and that glands could be influenced by β‐adrenoceptor subtypes and purinoceptors. Blockage of both these types of receptors offers a route to controlling apocrine secretion from axillary glands and reducing the opportunity for the development of bromhidrosis.     

Surgical subcision as a cost-effective and minimally invasive treatment for axillary osmidrosis

Background Axillary osmidrosis, characterized by unpleasant odor and occasional staining of clothing, is a personal discomfort and social impairment for people who suffer from it. Various types of surgical procedures involving instrumented‐assisted tools (lasers, ultrasonic, endoscope, and others) have shown relatively positive results; however, for patients in developing countries, especially in China, these treatments are inconvenient and cost‐ineffective. Objective To introduce a minimal incision surgical procedure with skin flap treatment that removes the apocrine sweat glands in the subcutaneous tissue through a 1‐cm‐long incision without instrument‐assisted tools. Method From July 2005 to October of 2007, 108 patients (68 women and 40 men) were treated with the minimal incision and cost‐effective surgical treatment by manual excision. A 1‐cm‐long incision is made in the axillary crease. Subcutaneous tissue and glands were removed with scissors through this incision. This procedure is repeated throughout the entire axilla until the axilla has essentially become a super‐thin flap. Result Malodor elimination was good in 206 out of 215 axillae (95.8%) treated, fair in nine (4.2%), and poor in zero (0%). The resulting scar is small and virtually invisible because it is only 1‐cm long and located in the axillary crease. Conclusion Treatment of axillary osmidrosis by manual excision through a 1‐cm incision is a convenient, efficient, cost‐effective, and relatively safe technique that results in high patient satisfaction and benefits patients and surgeons in developing countries. Axillary osmidrosis, a non‐life‐threatening condition characterized by unpleasant odor and occasional staining of clothing, is an annoying problem, particularly in Asian societies. For many people who suffer from this problem, this condition is a personal discomfort, a social impairment, and discourages patients from enjoying social or personal activities, especially young women. They are usually embarrassed by the smell during their daily activities and communication with other people.     

小切口潜行清除汗腺治疗腋臭

目的：寻求一种简便、有效治疗腋臭的外科于术方法。法：肿胀麻醉下通过1．0cm顺皮纹的小切口，于皮下脂肪层潜行分离一略大于腋毛边界的完整腔隙，用剪刀紧贴皮肤侧，剪除真皮下的脂肪浅层，清除其中的大汗腺及毛囊。果：78例患者均取得了较好的临床效果，无术后血肿、皮瓣坏死等并发症。腋部异味均消失，腋窝部仅留下1．0cm顺皮纹瘢痕。其中56例半年后随访，异味完全消失、瘢痕不明显：结论：小切口潜行清除汗腺术治疗腋臭是一种并发症少、瘢痕小、效果好的腋臭手术方法?     

等离子激光术和小切口吸刮术治疗腋臭的疗效及安全性比较

目的 比较等离子激光术和小切口吸刮术治疗腋臭的疗效及安全性.方法 2018年1月-2019年1月第四军医大学西京医院皮肤科纳入68例腋臭患者,将患者随机平均分为两组,实验组34例,采用等离子激光术治疗,对照组34例,采用小切口吸刮术治疗.持续随访12个月,比较两组患者的治疗效果和并发症发生情况.结果 实验组患者治疗有效...