"三明治"式唇病变切除成形术治疗葡萄酒色斑巨唇症疗效分析  

Efficacy of sandwich cheiloplasty on macrocheilia secondary to port-wine stain

作　　者：邰茂众 陈涛 葛春晓 李克雷 徐振国 秦中平 Tai Maozhong;Chen Tao;Ge Chunxiao;Li Kelei;Xu Zhenguo;Qin Zhongping(Department of Vascular Anomalies,Linyi Cancer Hospital,Linyi 276034,China)

机构地区：[1]山东省临沂市肿瘤医院省级血管瘤特色专科,临沂276034

出　　处：《中华医学美学美容杂志》2024年第6期576-581,共6页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：临沂市肿瘤医院面上项目(YNKY-2023-63)。

摘　　要：目的分析"三明治"式唇病变切除成形术治疗葡萄酒色斑(PWS)巨唇症的疗效。方法回顾性纳入2008年3月至2022年3月山东省临沂市肿瘤医院接受"三明治"式唇病变切除成形术治疗PWS巨唇症的患者43例,其中男20例,女23例,年龄37(4~69)岁。根据病变位置分为上唇组21例,下唇组22例。将切除标本进行组织病理学检查。术后保持切口局部清洁,观察切口血运,注意有无积液、裂开等。出院后每半年门诊复查,评价唇外形和功能,远期疗效分为3级:Ⅰ级(差)、Ⅱ级(中)、Ⅲ级(好)。两组间临床疗效等级资料的比较采用Mann-Whitney U检验。结果43例患者均接受"三明治"式唇病变切除成形术,其中40例接受1次手术,余3例因复发接受2次手术。43例次切口一期愈合,2例次部分唇黏膜坏死,1例次切口轻度裂开,均经换药后愈合。43例切除组织病理学检查结果均为毛细血管畸形。随访1~10年,远期疗效评价Ⅲ级(好)36例,Ⅱ级(中)7例,Ⅰ级(差)0例。其中上唇组Ⅱ级3例,Ⅲ级18例;下唇组Ⅱ级4例,Ⅲ级18例;两组患者的总体疗效差异无统计学意义(Z=0.342,P>0.05)。结论"三明治"式唇病变切除成形术治疗PWS巨唇症能有效祛除畸形血管病变,远期疗效较好。ObjectiveTo analyze the curative effect of sandwich cheiloplasty for the treatment of macrocheilia secondary to port-wine stain(PWS).MethodsA total of 43 patients,including 20 males and 23 females,aged 37.0 years(ranged from 4 to 69 years),who underwent sandwich cheiloplasty for the treatment of macrocheilia secondary to PWS from March 2008 to March 2022 were retrospectively enrolled.According to the location of the lesions,they were divided into two groups:upper lip group(21 cases)and lower lip group(22 cases).Pathological examinations were performed in all excised specimens.Postoperative attentions should be paid to keeping incisions locally clean,observing the blood supplying,and taking care of fluid accumulation or incision split.After discharge,the lip appearance and function were evaluated every six months in the outpatient department,and the long-term efficacy was further divided into three levels:gradeⅠ(poor),gradeⅡ(moderate),and gradeⅢ(good).The comparison of grade data named long-term efficacy between the two groups was conducted by Mann-Whitney U test.ResultsAll 43 patients underwent sandwich cheiloplasty,of which 40 patients received one operation,whereas the other 3 received two due to recurrences.One-stage incision healing was achieved in 43 cases,whereas partial mucosal necrosis appeared in 2 cases,and slight incision dehiscence occurred in 1 case,which healed well after local dressing change.The pathological examination results of 43 excised tissue specimens all showed capillary malformations.After follow-up for 1 to 10 years,long-term efficacy evaluation was made up as follows:36 cases were evaluated as gradeⅢ,7 cases as gradeⅡ,and 0 case as gradeⅠ.There were 18 cases of gradeⅢ,and 3 cases of gradeⅡin group A,compared to 18 cases of gradeⅢ,and 4 cases of gradeⅡin group B.By rank sum test,there was no significant difference in overal efficacy between the two groups(Z=0.342,P>0.05).ConclusionsSandwich cheiloplasty for the treatment of macrocheilia secondary to PWS effectively re

关 键 词：葡萄酒色斑 巨唇症 手术 血管畸形 唇 

分 类 号：R782[医药卫生—口腔医学]