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目的:探讨腋窝前、后、内、外4组小血管弓在腋臭根治术中的解剖标志性意义。方法:2015年2月至2018年8月，重庆市黔江中心医院对150例(300侧)腋臭患者行腋臭根治术，其中男80例，女70例，10~16岁60例，17~49岁90例。轻度21例，中度43例，重度86例。术前标注腋毛分布区范围，然后选取腋窝中间部位前后襞之间顺皮纹切口切开。锐性解剖出腋窝前、后、内、外侧4组小血管弓，测量血管弓与腋毛分布区边缘的最小距离。在各血管弓外侧1 cm、内侧(紧贴血管弓)、内侧1 cm、内侧2 cm处和腋筋膜表面分别切取直径约1 cm的组织送病理学检测。然后用组织剪彻底剪除腋窝前、后、内、外4组小血管弓所界定范围内的包括腋毛毛囊的浅筋膜组织。对切取组织行HE染色后进行病理学检查，观察有无顶泌汗腺，若有则计数为1，没有则计数为0，统计各处标本诊断为顶泌汗腺的比例并进行卡方检验。术后随访患者，评估手术切口愈合情况和腋臭残留情况。结果:150例患者均顺利完成手术，术中发现腋窝前、后、内、外4组小血管弓位置较为恒定。腋窝小血管弓所界定的范围均大于腋毛分布范围，90.00%(270/300)患者腋窝小血管弓距腋毛分布区边缘最小距离超过1.5 cm。术中发现腋窝前、后、内、外4组小血管弓外侧1 cm汗腺组织为0%(0/1 200)；血管弓内侧(紧贴血管弓)汗腺组织为1.33%(16/1 200)；血管弓内侧1 cm汗腺组织为100.00%(1 200/1 200)；血管弓内侧2 cm汗腺组织为100.00%(1 200/1 200)；腋筋膜表面汗腺组织为0%(0/1 200)。小血管弓内侧顶泌汗腺所占比例与小血管弓外侧比较，差异具有统计学意义(n χ2＝1 621.48, n P<0.001)。所有患者术后均切口愈合良好，无血肿形成及皮肤坏死。术后随访6个月至3年，均达到治愈，无一例残留或复发。n 结论:腋窝前、后、内、外4组小血管弓在腋臭根治术中具有解剖标志性意义，对规范腋臭根治术式有推进作用。“,”Objective:To investigate the anatomical significance of four groups of small vascular arches, which distributed in the anterior, posterior, medial and lateral of axillary in radical bromhidrosis surgeries.Methods:One hundred and fifty patients treated for bromhidrosis at Qianjiang Central Hospital of Chongqing from February 2015 to August 2018 were included in the study , including 80 males and 70 females. Sixty patients were aged 10-16 years old, and 90 were aged 17-49 years old. There were 21 mild cases, 43 moderate cases and 86 severe cases. The area of axillary hair was marked before surgery, and then the surgical incision was selected between the anterior and posterior folds of the middle part of the axilla. The anterior, posterior, medial, and lateral axillary small vascular arches were identified, and the minimum distance between the vascular arch and the margin of axillary hair area was measured. The tissues with a diameter of about 1 cm were removed at the lateral, medial (close to the vascular arch), 1 cm medial, 2 cm medial to the vascular arch and the surface of the axillary fascia for pathological examination. The superficial fascia including the axillary hair follicles in the area enclosed by the four vascular arcs were then completely cut off with tissue scissors. The specimen was examined microscopically after HE staining to determine whether it was apocrine sweat gland. If there were apocrine sweat glands, it was counted as 1, and if there were no apocrine sweat glands, it was counted as 0. The proportion of specimens diagnosed as apocrine sweat glands was counted. The patients were followed up to evaluate the incision healing and the residual bromhidrosis.Results:All the 150 cases were successfully completed, and it was found that the position of the 4 groups small vascular arch was relatively consistent. The range defined by the axillary small vessel arch was all larger than the axillary hair area, and the minimum distance between the axillary small vessel arch and the margin of axillary hair in 90.00%(270/300) patients was more than 1.5 cm. The apocrine sweat glands were found in 0% (0/1 200) of the samples taken from at 1cm lateral to vascular arch, 1.33%(16/1 200) at medial vascular arch (close to vascular arch), 100.00% (1 200/1 200)at 1 cm and 2 cm media to vascular arch. And the apocrine sweat glands on the surface of the axillary fascia were 0% (0/1 200). All patients were cured postoperatively, without residual glands or recurrence. All patients had good postoperative wound healing without hematoma and skin necrosis. After 6 months to 3 years follow-up, all the patients were cured without residual or recurrence.Conclusions:The four groups of small vascular arches, anterior, posterior, internal and external of axilla, haveanatomical significance in standardizing radical bromhidrosis surgery.