自体毛囊单位提取移植术治疗烧伤后小面积继发性瘢痕秃发的临床效果  

Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns

作　　者：戴娇娇 王玲 邱海洋 黄鑫怡 田雨欣 彭琴 刘洋 官浩 Jiaojiao Dai;Ling Wang;Haiyang Qiu;Xinyi Huang;Yuxin Tian;Qin Peng;Yang Liu;Hao Guan(Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院全军烧伤中心,烧伤与皮肤外科,西安710032

出　　处：《中华烧伤与创面修复杂志》2022年第6期532-537,共6页Chinese Journal of Burns And Wounds

基　　金：国家自然科学基金应急管理项目(81741105);教育部科技发展中心产学研创新基金(2021JH030)。

摘　　要：目的探讨自体毛囊单位提取(FUE)移植术治疗烧伤后小面积继发性瘢痕秃发(以下简称瘢痕秃发)的临床效果。方法采用回顾性观察性研究方法。根据采用的治疗方法,将空军军医大学第一附属医院2017年3月—2019年11月收治的采用自体FUE移植术治疗烧伤后小面积瘢痕秃发的18例患者[男12例、女6例,年龄(29±6)岁]纳入FUE移植组,将该单位同一时期由同一手术团队采用扩张皮瓣移植术治疗烧伤后小面积瘢痕秃发的18例患者[男13例、女5例,年龄(33±5)岁]纳入扩张皮瓣移植组。所有患者均随访1年以上,于末次随访时,采用Folliscope毛发检测系统测量移植区毛囊单位密度并计算毛发成活率,采用视觉模拟评分法(VAS)评估疗效,询问患者对治疗效果的满意度及随访期间的并发症发生情况,记录移植区毛发生长情况及头皮厚度、疼痛、瘙痒、色素沉着与表面粗糙度等表征。对数据行Fisher确切概率法检验、独立样本t检验。结果末次随访时,FUE移植组患者移植区毛囊单位密度为(46.8±2.0)个/cm^(2),明显高于扩张皮瓣移植组的(42.5±4.3)个/cm^(2)(t=3.84,P<0.01);2组患者的毛发成活率接近(P>0.05)。末次随访时,2组患者治疗效果VAS评分相近(P>0.05);FUE移植组患者对治疗效果的满意度评分为(8.6±1.1)分,明显高于扩张皮瓣移植组的(7.6±0.8)分(t=2.89,P<0.01)。随访期间,2组患者均无炎症、感染等并发症发生,仅扩张皮瓣移植组2例患者发生术后疼痛。末次随访时,2组患者移植区均被新生毛发覆盖,毛发生长方向与周围正常毛发基本一致;2组患者移植区头皮厚度、疼痛、瘙痒、色素沉着与表面粗糙度等表征情况比较,差异均无统计学意义(P>0.05)。结论采用自体FUE移植术治疗烧伤后小面积瘢痕秃发较扩张皮瓣移植术具有更好的远期毛囊单位密度和患者满意度,术后效果较好,具有良好的临床应用前景。Objective To explore the clinical effects of autologous follicular unit extraction(FUE)transplantation in the treatment of small area secondary cicatricial alopecia(hereinafter referred to as cicatricial alopecia)after burns.Methods A retrospective observational study was carried out.According to the adopted treatment methods,18 patients(12 males and 6 females,aged(29±6)years)who received autologous FUE transplantation for small area cicatricial alopecia after burns from March 2017 to November 2019 in the First Affiliated Hospital of Air Force Medical University were included in FUE transplantation group,and 18 patients(13 males and 5 females,aged(33±5)years)who were treated with expanded flap transplantation for small area cicatricial alopecia after burns by the same surgery team during the same period in the same hospital were included in expanded flap transplantation group.All the patients were followed up for more than 1 year.At the last follow-up,the follicular unit density in the transplanted area was measured by Folliscope hair detection system and the hair survival rate was calculated;the visual analogue scale(VAS)method was adopted to evaluate the treatment effect;patients were asked their satisfaction with the treatment effect and the occurrence of complications during follow-up;the hair growth and the scalp thickness,pain,pruritus,pigmentation,and surface roughness of the transplanted area were recorded.Data were statistically analyzed with Fisher's exact probability test and independent sample t test.Results At the last follow-up,the follicular unit density in the transplanted area of patients in FUE transplantation group was(46.8±2.0)/cm^(2),which was significantly higher than(42.5±4.3)/cm^(2) in expanded flap transplantation group(t=3.84,P<0.01);the hair survival rates of patients were similar between the two groups(P>0.05).At the last follow-up,VAS scores evaluating the treatment effect of patients were similar between the two groups(P>0.05);the satisfaction score of patients toward the treatme

关 键 词：烧伤 瘢痕 秃发 扩张术 毛囊单位提取 皮瓣移植术 

分 类 号：R622[医药卫生—整形外科]