解潮 夏秀莲 卢小婷 舒真 姜春庭 朱芬芳 方波 张本寿

[摘要]目的：探讨两种微创方法治疗腋臭的临床效果。方法：2016年6月-2020年6月笔者医院采用两种微创手术方法治疗腋臭患者共120例，分别采用小切口修剪术80例，A型肉毒毒素注射治疗40例。然后对两种手术治疗的患者临床效果与适应证进行回顾性分析比较。结果：两组患者术后经3～18个月的随访，治愈率分别为93.8%和89.1%，有效率均达100%，两种方法术后优良率比较，差异无统计学意义（P>0.05）。结论：两种方法治疗腋臭均有效，但基于严重异味的重度腋臭患者行小切口方法去除更为彻底;而对轻度异味的轻、中度患者行A型肉毒毒素注射治疗更为合适。

[关键词]腋臭;小切口修剪术;A型肉毒毒素;顶泌汗腺;效果

[中图分类号]R758.74+1    [文献标志码]A    [文章编号]1008-6455（2022）06-0049-03

Clinical Effects of Two Different Methods for the Treatment of Underarm Odor

XIE Chao，XIA Xiulian，LU Xiaoting，SHU Zhen，JIANG Chunting，ZHU Fenfang， FANG Bo，ZHANG Benshou

（Department of Plastic Surgery，Joint Logistics Support Unit No.904 Hospital PLA，Suzhou 215007，Jiangsu，China）

Abstract： Objective To explore the clinical effects of two minimally invasive methods in the treatment of underarm odor. Methods From June 2016 to June 2020， two surgical methods were used to treat a total of 120 patients with underarm odor. 80 cases were taken small incision resection， while the other 40 cases were adopted botulinum toxin injection treatment. Then we analyzed and compared the clinical effects and indications of the two surgical treatments. Results The two groups of patients were followed up for 3-18 months after operation. The cure rates were 93.8% and 89.1% respectively. The effective rate was 100%. There was no statistically significant difference to compare the excellent and good rate of the two methods （P>0.05）. Conclusion The two methods were both effective in treating underarm odor. Based on the patients with severe underarm odor， small incision resection method removed more thoroughly. For the patients with mild to moderate odor， botulinum toxin injection therapy was more appropriate.

Key words： underarm odor; small incision resection; botulinum toxin injection type A; apocrine sweat gland; treatment effect

腋臭亦稱“狐臭”，是整形外科一种常见疾病。常发于年轻女性患者，严重影响患者的身心健康，常给患者造成极大的心理障碍[1-2]，故患者的求治心理极为迫切。目前对腋臭的发病机制尚未完全明确，有研究表明[1]，腋臭的发生与腋部顶泌汗腺异常增生有密切关系，腋部顶泌大汗腺分泌物一般为无味、较黏稠的乳状液，含蛋白质、碳水化合物和脂肪类等，在经过腋窝的细菌发酵后，分解产生不饱和脂肪酸，继而散发出一种特殊的刺激性异味[2-5]。腋臭还与遗传和天气有密切关系，炎热多汗和运动时异味更为明显。青春期发病率最高，青壮年分泌最为活跃，而青春期患者的心理发育尚未成熟，若不积极治疗，会给患者日常生活及社交活动带来巨大影响，还可造成极其严重的心理压力和精神负担，甚至会产生自闭等心理障碍[6-7]。……