摘要
目的以美学修复为目标,探讨手术切除联合高频电针同步治疗眼睑分裂痣的临床效果。方法回顾性分析2019年1月至2023年12月陆军军医大学第一附属医院整形外科收治的眼睑分裂痣患儿资料,均采用手术联合高频电针气化剥脱治疗。对色素增厚明显、累及层次较深的色素痣采用手术切除,切除后残余表浅色素术中同步使用高频电针逐层气化剥脱,根据色素层次深浅确定剥脱深度,创面采用直接缝合或局部皮瓣转移进行修复。术后配合涂抹生长因子、抗瘢痕等综合治疗。观察术后切口愈合及不良反应发生情况;对比患儿治疗前及末次随访时的照片,根据色素清除率评估联合治疗效果(分为痊愈、显效、好转、无效);术后随访观察联合治疗后患儿眼睑功能、外观及术区瘢痕增生情况;电话随访调查患儿家属满意度(包括非常满意、满意和不满意)。结果共纳入5例患儿,男1例,女4例,年龄2~10岁,平均7岁,色素面积为0.3 cm×0.5 cm~1.7 cm×1.1 cm,术中色素切除范围为0.3 cm×0.4 cm~1.5 cm×1.1 cm。术后所有患儿切口愈合良好,无感染、皮瓣缺血坏死、切口裂开、出血等并发症发生。色素清除率均>90%,达痊愈效果。随访14~48个月,平均24.2个月,5例患儿眼部功能正常,无睁闭眼困难、溢泪等表现。眼部形态良好,无双眼大小不对称、上睑下垂、睑外翻、瘢痕增生等情况。患儿眼睑功能与美学效果理想,满意度均评价为非常满意。结论针对部分眼睑分裂痣患儿,采用手术切除联合高频电针有助于在去除色素的同时保留眼部美学形态,为眼睑分裂痣患儿提供了治疗新选择。
Objective To explore the clinical effects of combined surgical and high-frequency electro-acupuncture treatment for aesthetic restoration in children with eyelid split nevus.Methods A retrospective analysis was conducted on the medical records of children treated for eyelid split nevus in the Plastic Surgery Department of the First Affiliated Hospital of Army Medical University from January 2019 to December 2023.All cases underwent combined surgical excision and high-frequency electro-acupuncture vaporization.Surgical removal was used for nevi with significant pigmentation and deep involvement,and high-frequency electro-acupuncture was simultaneously applied to vaporize residual superficial pigmentation layer by layer based on the depth of the pigmentation.The wounds were repaired using either direct suturing or local flap transfer.Postoperative management included the application of growth factors and anti-scar treatments.Postoperative healing,adverse effects,and pigment clearance rate(categorized as healed,significant effect,improved,or ineffective)were observed by comparsons of the pre-treatment and the last follow-up photographs.Eyelid function,appearance,and scar hypertrophy were assessed during follow-up,and family satisfaction(categorized as very satisfied,satisfied,or dissatisfied)was surveyed via telephone.Results Five children were included,with one male and four females aged between 2 and 10 years(average 7 years).Pigment areas ranged from 0.3 cm×0.5 cm to 1.7 cm×1.1 cm,with surgical excision areas from 0.3 cm×0.4 cm to 1.5 cm×1.1 cm.All children had good wound healing without complications such as infection,flap ischemic necrosis,wound dehiscence or bleeding.The pigment clearance rate was over 90%,achieving a healed effect.During the follow-up of 14 to 48 months(average 24.2 months),all patients had normal eyelid function without difficulties in opening or closing the eyes,or epiphora.The eyelid appearance was satisfactory without asymmetry,ptosis,ectropion or hypertrophic scars.The aesthetic outc
作者
唐小清
张家平
杨青青
袁希
沈洁
Tang Xiaoqing;Zhang Jiaping;Yang Qingqing;Yuan Xi;Shen Jie(Department of Plastic Surgery,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《中华整形外科杂志》
CSCD
北大核心
2024年第7期736-742,共7页
Chinese Journal of Plastic Surgery
关键词
痣
色素
眼睑分裂痣
高频电针
手术切除
联合治疗
Nevus,pigmented
Eyelid split nevus
High frequency electro-aupuncture
Surgical excision
Combined treatment
