移植胡须毛囊单位治疗男性雄激素性脱发  

Transplantation of beard follicle units to treat androgenetic alopecia in men

作　　者：苗勇[1] 朱德聪 樊哲祥 王瑾[1] 曲茜[1] 陈若思[1] 张春华[1] 胡志奇[1] Miao Yong;Zhu Decong;Fan Zhexiang;Wang Jin;Qu Qian;Chen Ruosi;Zhang Chunhua;Hu Zhiqi(Department of Plastic and Aesthetic Surgery,Nanfang Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院整形美容外科,广州510515

出　　处：《中华整形外科杂志》2020年第6期606-611,共6页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金(81701929)。

摘　　要：目的探讨采用毛囊单位提取(follicular unit extraction,FUE)技术钻取胡须毛囊种植头发的安全性和有效性。方法回顾分析2017年3月至2019年4月南方医科大学南方医院整形美容外科,采用胡须种植头发且脱发等级在4级以上患者的临床资料。对胡须供区进行分区,逐个区域行肿胀麻醉后,采用内径为0.6 mm或0.7 mm的FUE锐针顺着胡须生长方向钻取胡须毛囊,根据胡须生长角度的变化调整FUE针与皮肤的夹角,进针深度为2~4 mm,以突破真皮层为度,FUE针的转速为2500~3000 r/min。将获取的胡须毛囊种植至秃发区。统计每例患者胡须毛囊单位的钻取总量和毛囊损伤率;术后3、10 d及术后1、3、9个月对患者进行随访,分别采用大体照片和毛发镜观察胡须毛囊供区创面愈合和并发症情况,以及种植区域胡须毛囊的生长情况。最后一次随访时,分别让医、患双方和第三方根据李克特量表对手术效果的满意度进行评估,分为非常满意(5分)、满意(4分)、不确定(3分)、不满意(2分)、非常不满意(1分)。结果本组共收集58例男性雄激素性脱发患者,年龄24~46岁。胡须毛囊单位钻取量为(2012±631)个,毛囊损伤率为(3.4±0.7)%。供区毛囊炎的发生率为10.3%(6/58),对症处理后1~3周内治愈。所有患者胡须毛囊供区均正常愈合,62.1%(36/58)的患者在毛发镜下可见到遗留的轻度白点,但均未遗留肉眼可见的瘢痕。种植区域胡须毛囊在术后5 d即生长牢固并正常生长,术后3周左右进入脱落期,5~7个月后绝大部分可以长出头皮,之后按照胡须的特性生长。医、患双方和第三方对术后效果的满意度评估分别为4.78、4.40和4.76分。结论对于胡须资源丰富的男性雄激素性脱发患者,采用FUE技术钻取胡须毛囊种植头发是一种既安全又有效的治疗方法。Objective To evaluate the safety and efficacy of transplanting beard to scalp using follicular unit extraction(FUE).Methods Data obtained from hirsute patients with extensive alopecia who underwent hair transplantation between March 2017 and April 2014 at Nanfang Hospital were analyzed.Individual beard hair follicular units(FUs)were harvested under tumescence along the direction of beard growth,using a hollow acute punch with an inner diameter of 0.6-0.7 mm driven with a motor machine.The angle between the punch and the skin is adjusted according to the angle of the beard.The depth of the punch is usually between 2-4 mm and just breaks through the dermis of the skin.The rotation speed of punch is 2500-3000 r/min.The harvested FUs were implanted to the bald area.The total amount of FUs harvested and the rate of FUs transection were recorded for each patient.Follow-up examinations were scheduled at 3 days,10 days,1 month,3 months and 9 months postoperatively to check for complications,wound healing and hair growth using portrait photograph and trichoscopy.Results A total of 58 patients male patients with advanced androgenetic alopecia(AGA)(Norwood-HamiltonⅤ-Ⅵ)were included in this study.The average harvested FUs was 2012±631 and the transection rate for beard FUs was(3.4±0.7)%.The incidence of donor folliculitis was 10.3%(6/58).Folliculitis was cured within 1-3 weeks after treatment.Although all the donor areas were healed normally,62.1%(36/58)of the patients had remaining mild white spots under the trichoscopy.There was no visible hypopigmented scars observed in the bare areas post-operation.The satisfaction scores of both doctors and patients and the third party were 4.78,4.40 and 4.76,respectively.Conclusions Transplanting beard FUs to bald scalp using FUE is a safe and effective for severe androgenetic alopecia with abundant beard.

关 键 词：毛发移植 胡须 雄激素性脱发 毛囊单位提取术 

分 类 号：R758.71[医药卫生—皮肤病学与性病学] R622[医药卫生—临床医学]