毛发移植术与头皮组织扩张术在大面积瘢痕性秃发修复中的应用分析  

Analysis of the efficacy of hair transplantation and scalp tissue expansion in the repair of extensive cicatricial alopecia

作　　者：蒋文杰 王梦 王博 成倩秋 毛文书[2] 张馨月 史俊荣 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院毛发移植中心,北京100144 [2]淮安市淮阴医院整形外科,江苏淮安223000 [3]邢台矿业集团总医院外科,河北邢台054000

出　　处：《中国美容整形外科杂志》2017年第9期525-528,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨毛发移植术和头皮组织扩张术修复大面积瘢痕性秃发的效果及适用范围。方法分析自2004年8月至2017年3月,分别采用毛发移植术(169例)和头皮组织扩张术(118例)治疗大面积瘢痕性秃发患者的临床资料。结果 169例行毛发移植的患者毛发生长自然、良好,术后11例出现毛囊炎,经75%乙醇涂擦后自愈;其中115例自觉毛发较为稀疏,71例行2次加密种植,23例行第3次加密种植。118例行头皮组织扩张术的患者术后扩张头皮瓣全部成活;21例对毛发生长方向不满意;6例毛发密度与周围毛发不一致;3例出现血肿,处理后未影响最终治疗效果。结论头皮组织扩张术是大面积头皮瘢痕最佳的治疗选择;对于年龄较大,或由于其他原因不适合使用扩张皮瓣修复的患者,宜采用毛发移植术进行修复。Objective To explore the efficacy and scope of hair transplantation and scalp tissue expansion in the repair of extensive cicatricial alopecia.Methods Between August 2004 and March 2017,the clinical data of patients suffering from extensive cicatricial alopecia who underwent hair transplantation （n=169） and scalp tissue expansion （n=118） were retrospectively analyzed.Results One hundred and sixty-nine patients who underwent hair transplantation achieved natural and good hair growth.Folliculitis was found in 11 patients and cured after 75% alcohol inunction.Among them,115 patients felt the hair was sparse.Seventy-one patients experienced a second transplantation to increase hair density,and 23 patients underwent a third transplantation.One hundred and eighteen patients underwent scalp tissue expansion.All flaps survived.Twenty-one patients were dissatisfied with the direction of hair growth,and the hair density was not consistent with peripheral hair in 6 patients.Hematoma was found in 3 patients,but did not impact the final treatment effect after the hematoma was addressed.Conclusion Scalp tissueexpansion was an optimal choice for extensive cicatricial alopecia.For older patients and cases who cannot tolerate expanded flap,hair transplantation should be adopted to repair the alopecia.

关 键 词：秃发 毛发移植 外科皮瓣 组织扩张术 瘢痕 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]