医用生物蛋白胶在面颈部扩张器埋置术中应用.doc

医用生物蛋白胶在面颈部扩张器埋置术中应用[摘要]目的：探讨在面颈部扩张器埋置术中，应用生物蛋白胶辅助创面止血以降低血肿发生率的可行性。方法：选取我科2006～2007年的40名面颈部软组织扩张术患者，随机分为对照组和用药组，用药组术中应用生物蛋白胶对创面辅助止血。观察分析两组术后引流液量等指标。结果：用药组术后扩张皮瓣下引流液量和血肿的发生率均明显低于对照组且对扩张器后期扩张无影响，无任何副作用发生。结论： 应用生物蛋白胶对创面辅助止血可明显减少面颈部扩张器置入后血肿的发生。 [关键词]生物蛋白胶；皮肤软组织扩张术；扩张器；引流量 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）10-1448-02 The application of biomedical fibrin glue in tissue expansion on the facial and cervical region YANG Jie,WANG Yu-rong,WANG lei,SUN Yu (Department of Plastic and Reconstruction, the Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan430022,Hubei,China) Abstract:ObjectiveTo investigate the application of biomedical fibrin glue in the placement of tissue expanders on the facial and cervical region.MethodsFrom 2006 to 2007, 40 patients were randomized to biomedical fibrin glue group and control one, volume of drainage and the incidence of complication were observed.ResultsThe volume of drainage and theincidence of hematoma after the operation of the biomedical fibrin glue group were all significantly lower than in the control group（P＜0.01）.ConclusionsThe application of biomedical fibrin glue in the expander implantation on the facial and cervical region can decrease the volume of drainage and effectively lowered the incidence of hematoma. Key words: biomedical fibrin glue;skin soft tissue expansion; tissue expander; volume of drainage 皮肤软组织扩张术（skin soft tissue expansion,STE）已广泛应用于整形外科领域，由于扩张后的皮肤在颜色、质地、结构等方面均与相邻部位的正常组织十分接近，而且扩张的皮瓣保留了感觉神经，具有正常感觉，较少产生供区缺损和继发畸形，其在面颈部瘢痕的治疗上取得了良好的效果。但统计表明面颈部软组织扩张后并发症的发生率明显高于其他部位。 近年来，国内、外有研究报道医用生物蛋白胶（纤维蛋白）作为生物粘合剂对慢性出血、大面积组织渗血有明显的止血作用[1]。在普通外科、口腔颌面外科等术中使用有良好的止血和防止吻合口瘘的功效。本文通过分析我科于2006～2007年对选取的40名面颈部软组织扩张术患者扩张器埋置时，随机应用生物蛋白胶对创面辅助止血的临床资料来讨论分析其在面颈部扩张器埋置术中的应用价值。 1资料和方法 1.1 病例与分组：选取住院病人40例，男28例，女12例。均为因面颈部烧伤后瘢痕或面颈部巨大色素痣行扩张器埋置术的患者。年龄9～42岁。扩张器容量：50ml,70ml,100ml,200ml,300ml。扩张器数量：面部34个，颈部20个。术前测血常规、凝血常规、肝肾功能均正常范围。 患者随机分为两组，每组20人。使用医用生物蛋白胶组(A组，扩张器n=26)和对照组(B组，扩张器n=2