扩张术后九种特殊并发症研究.docVIP

扩张术后九种特殊并发症研究摘　要　　目的:研究9种特殊皮肤扩张并发症的发生原因及处理方法。方法:统计8年的皮肤扩张病例829例,将特殊并发症分类,总结处理方法及结果。结果:特殊并发症共58例,占总病例数的7.0%,包括暂时性面神经麻痹、大血管损伤、神经牵拉痛、表皮水疱、炎症样血清肿、骨质增生、片状脱发和皮肤切口裂开,皮肤附件炎。其中,2例终止扩张治疗,14例二次手术处理并发症,1例出现永久性秃发。结论:预防和正确处理并发症是保证皮肤扩张术治疗效果的一个关键环节。 关键词　　组织扩张术　并发症 NINE SORTS OF SPECIAL COMPLICATIONS OF SKIN EXPANSION:ETIOLOGIC ANALYSIS AND MANAGEMENT Li Jiang　Wang Biao　Chen Mingfu　et al Departtment of Plastic Aesthetic Surgery General Hospital of Jinan Army(Jinan 250031) Abstract　Objective:To investigate the etiology and management of nine sorts of special complications from 829 cases of tissue expansions.Method:829 cases of complications during ten years were analysed and classified.Results:All complications were divided into nine corts,including paralysis of facial nerve,vessel injury,nerve stretching pains,epidermal blain,inflammatory seroma,bone hyperplasia,spot bald,incision dehiscence and skin annex inflammation,summed up 58 cases,in which two cases of expansion were ceased by removing the expanders,fourteen cases were cured through surgical procedures and two cases got permanent bald.Conclusion:Prevention and correct management of expansion. The author analysed the etiology of each complication and introduced the surgical management and the results.It must be emphasized that prevention and correct management of complications are very important in improving efficacy of skin expansion. Key words　Tissue expansion　Complication 　皮肤扩张术是整形外科的常规治疗技术,广泛用于组织缺损修复并有良好治疗效果。然而这项技术也有种类繁多的并发症(1),常见的有十多种,各家报道的发生率不尽相同(2)?(0～40%)。1990～1998年,我们实施829例皮肤扩张术,出现9种共计58例特殊并发症,本文对并发症的发生原因及其处理方法进行了探讨。 1　病例资料统计?选择1990年～1998年间全部皮肤扩张病例829例,出现9种共计58例特殊并发症,占本组病列总数的7.0%。58例特殊并发症患者年龄12岁～56岁,男性33例,女性25例。皮肤疤痕49例,黑毛痣8例,头皮巨大皮脂腺瘤1例。本组并发症包括暂时性运动神经麻痹、神经牵张痛、大血管损伤、皮肤水泡形成、炎性血清肿、骨质增生、片状秃发和皮肤切口裂开,以上并发症均单一发生。2例终止扩张治疗,12例通过二次手术消除并发症,1例为不可逆性秃发。 2　并发症原因分析与处理结果 2.1　暂时性面神经麻痹　共10例。面神经额支麻痹4例,颊支麻痹3例,下颌缘支麻痹3例,临床上分别表现为患侧额纹消失、鼻唇沟消失和降口角障碍。术后3～5天恢复,属麻醉所致,不需要特殊治疗。术后口角歪斜表现易引起心理障碍,特别需要向患者作解释工作,消除患者的顾虑。 2.