烧伤后耳廓瘢痕畸形分级标准的设定  

Setting of the grading criteria for scar deformity of auricle after burn

作　　者：全世明 王昱 徐佳 童德迪[3] 温春泉[4] QUAN Shiming;WANG Yu;XU Jia;TONG Dedi;WEN Chunquan(Department of Otolaryngology,The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Department of General Surgery,The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Department of Hand Surgery,Beijing Ji Shui Tan Hospital,Beijing 100035,China;Department of Burns and Plastic Surgery,Beijing Ji Shui Tan Hospital,Beijing 100035,China)

机构地区：[1]北京中医药大学第三附属医院耳鼻咽喉科,北京100029 [2]北京中医药大学第三附属医院普通外科,北京100029 [3]北京积水潭医院手外科,北京100035 [4]北京积水潭医院烧伤整形科,北京100035

出　　处：《安徽医药》2021年第7期1347-1349,共3页Anhui Medical and Pharmaceutical Journal

基　　金：国家卫生健康委能力建设和继续教育中心2019年专项基金资助项目(GWJJ2019100303)。

摘　　要：目的探讨烧伤后耳廓瘢痕畸形的严重程度的分级方法及对应的手术方式选择。方法对北京积水潭医院烧伤整形科2008年1月至2017年12月期间165例烧伤后耳廓瘢痕畸形住院病例,进行回顾性统计分析。并按照病人耳廓瘢痕范围,耳廓位置与颅耳角有无异常,耳轮、耳垂、耳甲腔、耳屏等耳廓结构的缺损情况,耳廓结构的辨识度等几个方面,进行四级评级分类。并分析手术方式与烧伤后耳廓瘢痕畸形分级的相关性。结果一级轻度耳廓瘢痕畸形74例,二级中度耳廓瘢痕畸形51例,三级中重度耳廓瘢痕畸形27例,四级重度耳廓瘢痕畸形13例。一级轻度耳廓瘢痕畸形最常采用瘢痕切除术,二级中度耳廓瘢痕畸形最常采用瘢痕切除+植皮术,三级中重度耳廓瘢痕畸形最常采用瘢痕切除+局部皮瓣转移+植皮术,四级重度耳廓瘢痕畸形最常采用瘢痕切除+皮瓣转移+植皮+耳廓成形术。结论本研究首次建立烧伤后耳廓瘢痕畸形的分级标准,有利于畸形严重程度判断,并能指导手术方式的选择。此分级标准简单易行,适合在临床工作中推广应用。Objective To explore the grading method of severity of auricular scar deformity after burn,and to selected corresponding surgical methods.Methods gery,Beijing Ji Shui Tan Hospital from January 2008 to December 2017 were retrospectively analyzed.According to the range of scar,the abnormal cranioauricular angle,the defect of the auricle anatomical units such as helix,earlobe,cavity of auricular concha and tragus,and the identification degree of the auricle structure,four grades were classified.The relationship between the main surgical methods used in the operation and the specific grades of classification of auricle scar deformity were analyzed.Results There were 74 cases of first grade with mild scar deformity of auricle,51 cases of second grade with moderate scar deformity of auricle,27 cases of third grade with moderate to severe scar deformity of auricle,and 13 cases of fourth grade with severe scar deformity of auricle.Scar excision is the most common methods for the first-grade mild scar deformity of auricle.Scar excision and skin grafting are the most common methods for the second-grade moderate scar deformity of auricle.Scar excision plus local skin flap transfer and skin grafting are the most common methods for the third-grade moderate and severe scar deformity of auricle.Scar excision plus skin flap transfer plus skin grafting and auricular plasty are the most common methods for the fourth-grade severe scar deformity of auricle.Conclusion Establishing the classification standard of auricular scar deformity post burn is helpful to judge the severity of deformity and to guide the choice of surgical methods.This grading criteria is simple and feasible,and suitable for clinical application.

关 键 词：烧伤 耳廓 瘢痕 参考标准 分级 整形 

分 类 号：R644[医药卫生—外科学] R764.71[医药卫生—临床医学]