小耳畸形患儿扩张法耳再造后强脉冲光脱毛术的效果  

Effect of intense pulsed light on hair removal in pediatric auricular reconstruction using tissue expander

作　　者：刘莹 张玲 胡守舵 黄绿萍 林琳 郑玲玉 Liu Ying;Zhang Ling;Hu Shuoduo;Huang Lvping;Lin Lin;Zheng Lingyu(Department of Plastic and Aesthetic Surgery,Beijing Hospital of Traditional Chinese Medicine,Beijing 100038,China;Laser Treatment Center,Department of Plastic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100144,China;Ear Reconstruction Center,Department of Plastic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100144,China)

机构地区：[1]北京中西医结合医院整形美容科,北京100038 [2]中国医学科学院北京协和医学院整形外科医院激光治疗中心,北京100144 [3]中国医学科学院北京协和医学院整形外科医院耳再造中心,北京100144

出　　处：《中华医学美学美容杂志》2024年第1期36-41,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家自然科学基金青年基金(81701926);北京协和医学院青年基金(YS202034)。

摘　　要：目的:探讨强脉冲光在扩张法耳再造过程的不同时期用于耳区脱毛的安全性和疗效。方法:2018年1月至2021年12月,中国医学科学院整形外科医院激光中心对小耳畸形患儿扩张法耳再造后不同治疗时期进行脱毛治疗131例,男61例、女70例,年龄6~10(7.6±1.8)岁,用德国Lumenis公司M22TM平台进行脱毛治疗和效果评估,并记录不良反应。结果:不同扩张器容积患儿在扩张期接受相同治疗次数后,毛发密度降低差异无统计学意义[15(13~19)比16(15~19)根/cm^(2),P>0.05]。接受2次脱毛治疗后,扩张期患儿毛发密度低于非扩张期患儿[15(13~19)比17(15~21)根/cm^(2),P<0.05]。扩张法患儿脱毛治疗次数与治疗效果高度相关[Kendall′stat b=0.74(95%CI:0.71~0.77),P<0.05]。发生3例毛囊炎、2例水疱,及时治疗后痊愈,均未造成扩张器暴露或软骨吸收。结论:强脉冲光脱毛术可安全地用于扩张法外耳再造手术的不同治疗阶段。扩张器容积不影响脱毛效率。扩张期脱毛效率优于非扩张期。5次治疗可达到再造耳"无毛"或"少毛"的理想效果,3次治疗可达到次优效果。Objective To investigate the safety and efficiency of depilation with intense pulsed light(IPL)in congenital microtia patients during different phase of reconstruction treatment sessions.Methods The hairy skin was treated with the M22TM system(Lumenis,German)using a filter of 695-1200 mm.A three pluses mode of the radiant setting with a pulse width of 3.5 ms,a delay of 60 ms,and an energy density of 16-18 mJ/cm^(2) was applied in the expanded patients.Depilation efficacy was evaluated as follows:excellent(hair density reduction>75%),good(50%-75%),fair(25%-50%),and poor(<25%).The depilation effect was compared between different phases.And the adverse effect was observed.Results A total of 131 cases were included.There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments[15(13-19)vs.16(15-19)root/cm^(2),Wilcoxon rank analysis].The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments[15(13-19)vs.17(15-21)root/cm^(2),P<0.05,Wilcoxon rank analysis].The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received[Kendall′stat b=0.74(95%CI:0.71-0.77),P<0.05].There were 3 cases of folliculitis,2 cases of blisters occurred in this study,and no expander exposure and cartilage absorption were observed.Conclusions Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander.The volume of the expander does not significantly affect the hair removal efficiency.Depilation in the expansion phase is more efficient than that in the non-expansion phase,and the ideal result of"hair-free"or"less hairy"reconstructed ears can be achieved in 5 treatments,with suboptimal results in 3 treatments.

关 键 词：先天性小耳畸形 强脉冲光 脱毛 耳再造术 软组织扩张 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]