本文選題：腋臭 + 大汗腺��； 參考：《第四軍醫(yī)大學》2010年碩士論文

【摘要】：腋臭是一種常見病,一般認為與大汗腺分泌功能異常有關。隨著人們生活水平的提高和社交活動的增多,腋臭已經成為患者的嚴重心理負擔,影響正常的生活和工作。目前國內外治療腋臭的方法眾多,但大都因為對腋臭的發(fā)生機制或對大汗腺的分布不明確而難以達到理想的治療效果。我們在查閱大量文獻的基礎上,對腋臭的發(fā)病機制、大汗腺的分布范圍做了全面的了解,對以往的治療方法進行了全面的分析,總結了以往腋臭治療方法的優(yōu)缺點,設計了一種新的治療腋臭的手術方法:腫脹麻醉吸刮修剪法治療腋臭。臨床應用87例,對臨床療效進行觀察分析,并對20例漢族腋臭患者大汗腺的分布進行了驗證性檢測。 目的:通過對漢族腋臭患者大汗腺的分布范圍的驗證性檢測,探索能夠比較徹底的祛除腋臭患者大汗腺,術后外觀、功能良好的治療腋臭的手術方法,并進行臨床應用。 方法:對我科2007年9月至2009年10月期間前來就診的87例腋臭患者,使用順腋皺襞切口腫脹麻醉吸刮修剪法治療,對其中20例患者腋部不同部位的皮膚和皮下組織進行組織學檢測,檢查腋臭患者大汗腺的分布情況。經過隨訪,觀察臨床療效。 結果:20例漢族腋臭患者大汗腺分布的廣度和層次與腋毛毛囊的分布基本相似但有差別,分布層次主要在真皮網狀層和淺層脂肪層,分布范圍約至腋毛邊緣1.0cm處;87例使用腫脹麻醉吸刮修剪法治療的腋臭患者隨訪3-12個月,痊愈86例,好轉1例,總有效率100%,早期并發(fā)癥發(fā)生率8.0%,其中皮下血腫3例(3.4%),皮膚部分壞死2例(2.3%),切口延期愈合2例(2.3%);后期并發(fā)癥發(fā)生率1.1%:臭味復發(fā)1例(1.1%)。 結論:漢族腋臭患者大汗腺分布層次主要在真皮網狀層和淺層脂肪層,范圍主要在腋毛生長區(qū)及腋毛生長區(qū)外1.0cm范圍內。腫脹麻醉吸刮修剪法治療腋臭能夠比較徹底的祛除大汗腺,是一種效果確切、治愈率高、并發(fā)癥少、對患者上肢功能和腋部外觀影響小的手術方法,值得推廣使用。
[Abstract]:Axillary odor is a common disease, generally considered to be associated with abnormal secretion of sweat glands. With the improvement of people's living standard and the increase of social activities, axillary odor has become a serious psychological burden for patients, affecting normal life and work. There are many ways to treat axillary odor at home and abroad, but it is difficult to achieve the ideal therapeutic effect because of the unclear mechanism of axillary smelly or the distribution of sweat gland. On the basis of consulting a large number of literatures, we have made a comprehensive understanding of the pathogenesis of axillary odor and the distribution of hypersweat glands. We have made a comprehensive analysis of the previous treatment methods and summarized the advantages and disadvantages of the previous treatment methods. A new operative method for the treatment of axillary smelly was designed: swelling anesthesia, suction, curettage and pruning. 87 cases of clinical application were observed and analyzed, and the distribution of large sweat glands in 20 patients with axillary osmidrosis in Han nationality was examined by confirmatory test. Objective: to detect the distribution of hyperhidrosis glands in patients with axillary odor in Han nationality, and to explore the operative method of removing the hypersweat glands completely and treating axillary smelly with good function after operation, and to carry on the clinical application. Methods: 87 patients with axillary osmidrosis from September 2007 to October 2009 were treated with swelling anesthesia and curettage through axillary fold incision. Histopathological examination was performed on the skin and subcutaneous tissue of 20 patients with axillary osmidrosis. The clinical effect was observed after follow-up. Results the distribution of hypersweat glands in 20 patients with axillary odor was similar to that in the axillary hair follicles. The distribution levels were mainly in the dermis reticular layer and the superficial fat layer. 87 patients with axillary osmidrosis treated by swelling anesthesia suction and pruning were followed up for 3 to 12 months. 86 cases were cured and 1 case improved. The total effective rate was 100, and the incidence of early complications was 8.0. 3 cases had subcutaneous hematoma, 2 cases had partial necrosis of skin, 2 cases had delayed healing of incision and 2 cases had delayed healing. Conclusion: the distribution of hypersweat glands in patients with axillary osmidrosis in Han nationality is mainly in the dermis reticular layer and superficial adipose layer, and mainly in the axillary hair growth area and 1.0cm outside the axillary hair growth area. The swelling-anesthetic curettage and pruning method can remove the hyperhidrosis completely. It is an effective method with high cure rate and less complications. It has little influence on the function of the upper limb and the appearance of the armpit. It is worth popularizing and using.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R758.741

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本文編號：1824818