短程持续组织扩张技术的临床应用

李　江　王　标　鲁开化等

(1.济南军区总医院整形美容外科济南250031;2.第四军医大学西京医院整形外科中心)

[摘要]目的:研究住院周期最短的理想快速扩张法。方法:选择117例皮肤瘢痕患者,分成间断快速扩张组(IFTE)和短疗程持续扩张组(SPTE)。IFTE组采用平行切口埋植扩张器,术后10天开始作间断快速扩张。SPTE组经垂直小切口埋植扩张器,术中大量注水扩张,术后持续扩张。结果:所有患者均顺利完成快速扩张并获得满意治疗效果。IFTE组平均扩张时间16.8天,平均住院时间为45.3天。SPTE组平均扩张时间为11.7天,平均住时间为32.4天。SPTE组并发症发生率低于IFTE组。结论:短程持续组织扩张技术治疗结果可靠,可有效地减少患者的住院时间。

[关键词]组织扩张术住院时间皮肤瘢痕

[中图分类号]R622[文献标识码]B[文章编号]1008-6455(2000)05-0358-02

A INVESTIGATION ON SHORT PERIOD CONTINUOUS TISSUE EXPANSION

LI Jiang,Wang Biao,LU Kaihua,et al.

Plastic and Aesthetic Department,General Hospital of Jinan Army,(Shandong 250031)

[Abstract]Objective:To study a new continuous expansion procedure for short therapy period.Methods: 117 cases of patients with skin cicatrix were divided into intermittent fast tissue expansion group (IFTE) and short period tissue expansion group (SPTE).In IFTE group,expanders were placed into subcutaneous pockets through traditional parallel incisions and rapidly inflated 10 days after expander insertion.In SPTE group,expanders were placed into subcutaneous pockets through short perpendicular incisions and inflated interaoperatively.Continuous expansion was begun 2 days after expander insertion under constant pressure.Results:All expanders were expanded successfully and every patients got good results.Average expansion time of 16.8 days was achieved in IFTE group,against 11.7 days in SPTE group.Average hospitalization duration was 45.3 days in IFTE group,against 32.4 days in SPTE group.The complication rate in SPTE group was lower than that of IFTE group.Conclusion:The procedure of shotr of short continuous tissue expansion could decrease the hospitalization time of patienst effectively with good clinic results.

[Keywords]Tissue expansionHospitalization durationSkin cicatrix

皮肤扩张术已被广泛用于临床,接受皮肤扩张治疗的患者也越来越多。我们在临床研究中发现,快速扩张术的治疗周期虽然比常规扩张法短,但治疗过程中的时间安排仍具有弹性,可进一步缩短。为此,我们设计出短疗程皮肤快速扩张治疗程序,并与间断快速扩张作了对比研究。

1病例选择及分组テし赳：刍颊117例,男性49例,女性68例,随机分成两组。短程持续扩张(SPTE)组:57例,年龄22.35±11.76岁。间断快速扩张(IFTE)组。(对照组):60例,年龄24.19±12.25岁。患者使用扩张器1～6个,容量50ml～500ml。

2治疗方法

2.1SPTE组治疗程序

2.1.1扩张方案セ颊呷朐汉5天内接受扩张器植入手术,术中大量注水扩张,术后3天开始作持续皮肤扩张,完成扩张后2天作扩张皮瓣转移修复术,8天～12天后拆线出院。……