烧伤后色素脱失的治疗研究

唐殿成　侯健等

唐殿成侯健王洪王琪王德宇王文松

(大连市第四人民医院烧伤整形科辽宁 大连116031)

唐殿成男1966年生,1990年毕业于中国医科大学儿科系,1997年被选为大连市跨世纪拔尖人才,送美国培训。1998年在BUNS杂志发表论文一篇。现为大连市第四人民医院(大连烧伤整形医院)整形科主治医师。已发表论文多篇。[摘要]目的:探讨烧伤后色素脱失的理想治疗方法。方法:利用微晶磨疤机磨除色素脱失部位(白斑)的表皮,放大2.5倍观察至出现均匀点状出血为止,再利用电动取皮机取下超薄刃厚皮移植于磨削创面,共治疗8例患者,10处白斑。结果:10处白斑均重新着色。移植表皮与周围皮肤颜色配比良好,界限不明显,无皮片挛缩,随访3月～20月,无白斑复发现象,有8处白斑术后获得极为满意效果。结论:通过带黑色素细胞的自体表皮移植从而间接实现黑色素细胞的移植,使白斑永久着色。我们认为这是一种理想的烧伤后色素脱失的治疗方法,也可应用于白癜风的治疗。

[关键词]烧伤色素脱失黑色素细胞自体表皮移植

[中图分类号]R622[文献标识码]A[文章编号]1008-6455(2000)09-0283-03

THE THERAPEUTIC RESEARCH ON

DEPIGMENTATION AFTER BURN INJURY

TANG Dian-chengHOU JianWANG Hong, et al.

Depart.plastic surgery,the No.4 Hospital,Dalian(Liaoning 116031)

[Abstract]Objective:Τo investigate an ideal therapeutic method on depigmentation after burn injury.Methods:We applied an advanced micro-dermabrader to remove the epidermis of depigmental regions until it presents uniform punctate bleeding(under×2.5magnifier),then use warm salt solution to stop bleeding.We use electro-dermatone to harvest free skin sheet rich in melanocyte to graft the abraded regions,and dress the regions with gauze,plastre splint can be used necessarily.Result:We have performed 10 operations on 8 patients,during the follow-up of 3months～22 months,6 patients have received excellent results,and the others results are also satisfied.They all have the hypopigmental regions pigmented permanently,and no scar leaved on donor regions.Conclusion:This is an ideal method for depigmentation after burn injury and can be used for any other vitiligos.

[Key words]Burn DepigmentationMelanocyteAutologous epidermal grafting

浅度烧伤愈后易引起色素沉着,而深度烧伤疤痕愈后往往会发生色素脱失(depigmentation 即皮肤白斑)^[1],常见于手、面、颈、足等暴露部位。采用药物保守治疗虽可以获得暂时改善,但是永久的治疗必须靠表皮移植^〔2〕。国外学者在这方面做了大量工作,以探索理想的色素脱失治疗方法。我们自1997年开始,对烧伤后色素脱失采用微晶磨削加自体表皮移植手术,获得满意的临床效果。……