全耳廓再造术后湿疹的处理策略  

Management of Eczema After Auricular Reconstruction

作　　者：钱瑾 傅窈窈 章庆国 张天宇 QIAN Jin;FU Yaoyao;ZHANG Qingguo;ZHANG Tianyu(Department of Auricular Reconstruction,Plastic Surgery Hospital,Chinese Academy of Medical Science and Peking Union Medical College;Department of Facial Plastic and Reconstructive Surgery,Institute of Otolaryngology,Eye&Ear,Nose and Throat Hospital of Fudan University)

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 [2]复旦大学附属眼耳鼻喉科医院眼耳鼻整形外科耳鼻喉科研究院

出　　处：《中华耳科学杂志》2018年第5期659-662,共4页Chinese Journal of Otology

基　　金：国家自然科学基金;项目编号:81500786;上海市科委项目;项目编号:15411969500~~

摘　　要：目的探讨全耳廓再造术后湿疹的发生及处理策略。方法回顾性分析2015年1月至2017年11月在中国医学科学院整形外科医院耳再造二中心行全耳廓再造术的患者,Nagata法610例,扩张法580例。收集其中发生湿疹的患者。根据湿疹发生的范围定义湿疹的轻重程度,耳廓局部发生的糜烂渗出的定义为轻度湿疹,全耳廓发生糜烂渗出的定义为重度湿疹。轻症患者隔天应用生理盐水湿敷,重症患者隔天应用生理盐水湿敷结合口服抗组胺药及预防性口服抗生素,随访观察2月。结果共收集耳再造术后轻症湿疹患者18例,其中Nagata法10例,扩张法8例。重症湿疹患者5例,其中Nagata法3例,扩张法2例。换药2-6次后完全好转,均未发生软骨支架外露及感染。结论耳再造术后湿疹是感染的易感因素,需要及时处理。轻症湿疹应用生理盐水湿敷清洁,重症患者结合口服抗组胺药及预防性抗生素使用,多能控制。Objective To report the incidence of eczema after auricular reconstruction and its management.Methods Data of cases of ear reconstruction completed at the Second Center of Ear Reconstruction,Plastic Surgery Hospital,Chinese Academy of Medical Science,between January 2015 and November 2017 using the Nagata method(n=610)or skin expansion method(n=580)were retrospectively reviewed to identify cases complicated with eczema.Eczema was categorized as mild if affecting only part of the auricle and as severe if affecting the entire auricle.Mild eczema was treated with saline,while severe cases were treated with additional oral antihistamine and prophylactic antibiotics.Patients were followed up for 2 months.Results There were 18 cases with local postoperative eczema,10 involving the Nagata method and 8 involving skin expansion.Five of these cases were categorized as severe,with 3 involving the Nagata method and 2 involving skin expansion,in which eczema completely resolved after 2-6 sessions of saline irrigation,with no occurrence of cartilage framework exposure or infection.Conclusion Post-auricular reconstruction eczema,a risk factor for infection,should be promptly treated.Saline irrigation is a good intervention to control eczema.Oral antihistamine and prophylactic antibiotics may sometimes be needed for severe eczema.

关 键 词：小耳畸形 耳再造 湿疹 

分 类 号：R764[医药卫生—耳鼻咽喉科]