本文選題：腋臭　切入點：A型肉毒毒素　出處：《大連醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究采用A型肉毒毒素局部注射、小切口大汗腺剪除術(shù)、微創(chuàng)負(fù)壓抽吸術(shù)這三種方法分別治療腋臭,從術(shù)后療效、術(shù)后并發(fā)癥、術(shù)后復(fù)發(fā)率等多方面綜合比較和評估,旨在給腋臭患者選擇治療方式時提供指導(dǎo),提高腋臭治療的滿意度。方法:自2015年4月-2016年6月間的92例腋臭患者,分別采用A型肉毒毒素局部注射、小切口大汗腺剪除術(shù)、微創(chuàng)負(fù)壓抽吸術(shù)這三種腋臭治療方法進(jìn)行治療,并隨訪6至9個月。收集患者資料(年齡、性別、腋臭程度等)、術(shù)后療效、術(shù)后并發(fā)癥(如瘀青、血腫、皮膚壞死、切口裂開、局部感染、局部麻木和瘢痕攣縮等)、術(shù)后復(fù)發(fā)率等方面的資料,并進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:A型肉毒毒素局部注射組(A組)、小切口大汗腺剪除術(shù)組(B組)、微創(chuàng)負(fù)壓抽吸術(shù)組(C組)三組間年齡、性別及腋臭嚴(yán)重程度均采用x2檢驗,分別為x2=24.12,P=0.84,x2=0.12,P=0.94,x2=0.16,P=0.997,P值均大于0.05,說明年齡、性別及腋臭嚴(yán)重程度在三組間的差異無統(tǒng)計學(xué)意義。對三組療效進(jìn)行統(tǒng)計學(xué)分析,輕度腋臭三種方法的有效率均為100%,無差異。三種治療方式對中度腋臭的療效分別為87.5%、92.3%、87.5%,進(jìn)行x2檢驗,x2=1.59,P=0.452,P0.05,差異無統(tǒng)計學(xué)意義。三種治療方式對重度腋臭的療效分別為57.1%、84.6%、62.5%,進(jìn)行x2檢驗,x2=19.54,P0.01,有顯著統(tǒng)計學(xué)差異;再分別每兩組對重度腋臭療效進(jìn)行x2檢驗,A組與B組(x2=18.31,P0.01)及B組與C組(x2=12.55,P0.01)有顯著統(tǒng)計學(xué)差異;而A組與C組(x2=0.61,P=0.436,P0.05)差異無統(tǒng)計學(xué)意義。三組并發(fā)癥總發(fā)生率分別為2.2%、25%、10.9%,行x2檢驗,x2=23.88,P0.01,有顯著統(tǒng)計學(xué)差異。再分別每兩組并發(fā)癥總發(fā)生率進(jìn)行x2檢驗,A組與B組(x2=22.12,P0.01)及B組與C組(x2=6.75,P=0.009,P0.01)有顯著統(tǒng)計學(xué)差異;A組與C組(x2=6.18,P=0.013,P0.05)有統(tǒng)計學(xué)差異。三組半年內(nèi)復(fù)發(fā)率分別為78.9%、0.0%、10.5%,行x2檢驗(x2=175.50,P0.01)有顯著統(tǒng)計學(xué)差異;再分別每兩組復(fù)發(fā)率進(jìn)行x2檢驗,A組與B組(x2=130.31,P0.01),B組與C組(x2=11.08,P=0.001,P0.01)及A組與C組(x2=94.64,P0.01)均有顯著統(tǒng)計學(xué)差異。結(jié)論:1.療效方面,對于輕度和中度的腋臭,三種方法的有效率無明顯差異,對于重度腋臭,小切口大汗腺剪除術(shù)優(yōu)于其它兩種治療方式。2.并發(fā)癥的發(fā)生率方面,小切口大汗腺剪除術(shù)最高,微創(chuàng)負(fù)壓抽吸術(shù)次之,A型肉毒毒素局部注射最低。3.術(shù)后半年內(nèi)復(fù)發(fā)率方面,小切口大汗腺剪除術(shù)最低,微創(chuàng)負(fù)壓抽吸術(shù)次之,A型肉毒毒素局部注射最高。
[Abstract]:Objective: to compare and evaluate the treatment of axillary osmidrosis by local injection of botulinum toxin A, small incision excision of sweat gland and minimally invasive suction under negative pressure, in terms of postoperative efficacy, postoperative complications, postoperative recurrence rate and so on. Methods: from April 2015 to June 2016, 92 patients with axillary osmidrosis were treated with botulinum toxin A (Botulinum toxin A) local injection and small incision large sweat gland excision. The patients were followed up for 6 to 9 months. The data of patients (age, sex, degree of axillary odor, etc.), postoperative efficacy, postoperative complications (such as bruising, hematoma, skin necrosis, incision rupture, etc.) were collected. Information on local infection, local numbness, scar contracture, postoperative recurrence rate, etc. Results the age, sex and severity of axillary osmidrosis were measured by x2 test among the three groups: group A, small incision hyperhidrosis group (group B) and minimally invasive negative pressure aspiration group (group C). The results showed that there was no significant difference in age, sex and axillary odor severity between the three groups, and the difference was not statistically significant among the three groups, and the curative effect of the three groups was analyzed statistically, and the difference between the three groups was not statistically significant, which indicated that there was no significant difference in age, sex and the severity of axillary osmidrosis among the three groups, and there was no significant difference between the three groups in terms of age, sex and the severity of axillary osmidrosis. The effective rate of the three methods was 100, no difference was found among the three methods. The curative effect of the three treatments was 87.5% and 92.3%, respectively, and the x2 test was carried out. There was no significant difference between the three methods. The curative effects of the three treatments for the severe axillary odor were 57.1and 84.6mg / kg, respectively. X2 test was performed with 19.54% (P0.01), and there was significant difference between the two groups (P < 0.05). There were significant differences between group A and group B (P 0.01) and group B and group C (P 0.01). There was no significant difference between group A and group C (P 0.05). The total incidence of complications in the three groups was 2.2 and 2510.9, respectively. There was significant statistical difference in the total incidence of complications between group A and group C. the total incidence of complications in group A and group B were examined by x2 test, and the total incidence of complications in group A and group B was 22.12 (P 0.01) and group B (P 0.01) respectively, and the total incidence of complications in group A was significantly higher than that in group C (P 0.01), and the total incidence of complications in group A was higher than that in group B (P 0.01). There was significant difference between group A and group C (P 0.05). The recurrence rate of the three groups within half a year was 78.9% and 10.5, respectively. There was a significant difference between the three groups by x2 test x 2175.50 (P0.01), and there was a significant difference between group A and group C (P 0.05), and the recurrence rate of the three groups within half a year was 78.9% and 10.5% respectively, and there was a significant difference between the three groups by x2 test (x2175.50, P0.01). The recurrence rates of group A and group B were examined by x2 test, respectively. There were significant differences between group A and group B and group C, respectively. Conclusion there was no significant difference among the three methods for mild and moderate axillary osmidrosis, as well as for group A and group C (P 0.01, P 0.01, P 0.01, P 0.01, respectively). Conclusion: there is no significant difference in the efficacy of the three methods in the treatment of mild and moderate axillary osmidrosis, and there is no significant difference between group A and group C in the treatment of axillary osmidrosis, and there is no significant difference between the three methods in the treatment of axillary odor. For severe axillary osmidrosis, small incision large sweat gland cutting is superior to the other two treatment methods .2.The incidence of complications is the highest in small incision large sweat gland cutting. The local injection rate of botulinum toxin A was the lowest in minimally invasive negative pressure aspiration. The recurrence rate was the lowest in small incision hyperhidrosis and the highest in minimally invasive negative pressure aspiration.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R758.741

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