内镜技术在面颈部扩张器置入术中的应用  

Tissue expansion on the neck with endoscopy

作　　者：顾斌[1] 李青峰[1] 刘凯[1] 沈国雄[1] 

机构地区：[1]上海第二医科大学附属第九人民医院整复外科,上海200011

出　　处：《中华医学美学美容杂志》2004年第5期286-288,共3页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：上海市整形外科临床医疗中心建设资助项目ZX0 2A10;上海市卫生发展基金"百人计划"资助项目 97BRO13

摘　　要：目的　探讨运用内镜技术行面颈部扩张器置入的方法及其优点。方法　采用远位、垂直或锯齿状小切口 ,在内镜“直视”下锐性与钝性交替行皮下分离腔隙 ,运用外部丝线缝合悬吊皮肤维持腔隙 ,扩张器置入后 ,放置引流 ,注射壶外置。术中即刻注水 ,注水量为扩张器容量的 1/ 5～ 1/ 2不等 ,术后第 2天开始按常规注水。观察术后第 1、2天术区引流量 ,皮肤扩张所需时间及并发症发生情况。结果　 2 0 0 2年 11月至 2 0 0 3年 11月 ,运用内镜行面颈部扩张器置入 2 2例。术后第 1、2天引流量 5～ 2 0ml,较常规方法明显减少。皮肤扩张所需时间 1.0～ 1.5个月 ,较常规方法提前 2～ 3周完成。无血肿、切口裂开、扩张器外露等并发症发生。术后效果满意。结论　运用内镜行面颈部扩张器置入能减少组织创伤 ,缩短皮肤扩张所需时间 。Objective To describe a technique for the plac ement of tissue expanders on the neck with endoscopy. Methods The incision was small, vertical, serrate, and far away from the area that was to be expanded. With the assistance of endoscope, the skin was undermined t o conduct the pocket in which the expander could be positioned. The blunt dissec tion and acute dissection were used alternatively. The capacity was maintained w ith a filament suspending outside. After the expander was implanted, negative pr essure drainage was performed with expander pot outside.Then, the expander was i nflated intraoperatively with a volume of 1/5 to 1/2 of the expander capacity, a nd routine injection was carried out since the second day postoperatively. Drain age volume on the first and second day after surgery and time required for skin distention as well as the incidence of complication were observed. R esults Between December 2002 and December 2003, endoscope-aided exp ander implantation on the neck was undertaken on 22 patients. The drainage volum e on the first and second day after surgery ranged from 5 to 20ml, significantly less than normal value. The time required for skin distention was 1-1.5 months , which was 2-3 weeks shortened. Complications including haematoma, disruption of wound and exposure of expander were not found. The efficacy of the surgery wa s satisfactory. Conclusion Endoscope-aided expander implantat ion on the neck can alleviate injury to tissue, decrease the time required for s kin distention and reduce the incidence of complications. [

关 键 词：内镜 面颈部扩张器置入术 手术方法 整形手术 

分 类 号：R622[医药卫生—整形外科]