【摘要】：目的:探討應(yīng)用耳后彎曲矩形滑行推進(jìn)皮瓣修復(fù)中重度耳輪皮膚缺損的方法和應(yīng)用。方法:自2015年3月至2016年7月,采集山西醫(yī)科大學(xué)第一附屬醫(yī)院整形燒傷外科診治的20例中重度耳輪皮膚缺損患者(耳輪皮膚缺損的原因包含各種外傷,人或動物咬傷,腫瘤等),其采用耳后彎曲矩形滑行推進(jìn)皮瓣的方法進(jìn)行修復(fù),一期行耳輪缺損區(qū)清創(chuàng)準(zhǔn)備/腫物切除—?dú)埗硕舐裰残g(shù),6周后二期行耳輪斷蒂成形術(shù),耳后供瓣區(qū)應(yīng)用乳突區(qū)彎曲矩形滑行推進(jìn)皮瓣進(jìn)行修復(fù)。所有手術(shù)均由同一位主刀醫(yī)生完成,術(shù)后隨訪觀察時間為6-15個月。采用直接觀察法,POSAS量表,評價應(yīng)用耳后彎曲矩形滑行推進(jìn)皮瓣修復(fù)中重度耳輪皮膚缺損的術(shù)后效果。計量資料用均數(shù)±標(biāo)準(zhǔn)差()表示,計數(shù)資料用百分?jǐn)?shù)表示,患者與觀察者之間對術(shù)后效果的滿意度用卡方檢驗(yàn)。全部資料用SPSS17.0for windows統(tǒng)計。檢驗(yàn)水準(zhǔn)α=0.05。3.研究結(jié)果(1)直接觀察法:本課題20例患者無一出現(xiàn)感染、傷口哆開,斷蒂及滑行推進(jìn)皮瓣均成活良好,其中18例患者患側(cè)耳外形良好,輪廓流暢,厚度、色澤等與周圍皮膚相似,耳后乳突區(qū)瘢痕增生不明顯,接口處無明顯凹凸感;其中1例患者術(shù)后患側(cè)耳略顯臃腫,線條不夠流暢,且色澤較周圍皮膚較深;1例患者耳后耳輪及乳突區(qū)瘢痕增生比較明顯。sx±(2)POSAS量表結(jié)果:患者術(shù)后滿意度達(dá)85%,觀察者滿意度達(dá)90%,且患者與觀察者滿意度評估差別無統(tǒng)計學(xué)意義。結(jié)論:應(yīng)用耳后彎曲矩形滑行推進(jìn)皮瓣修復(fù)中重度耳輪皮膚缺損,具有操作簡單,術(shù)后外觀良好,視覺差異性小,供瓣區(qū)瘢痕隱蔽,值得臨床推廣應(yīng)用。
[Abstract]:Objective: to explore the method and application of retroauricular curved rectangular sliding flap for repairing moderate and severe ear wheel skin defect. Methods: from March 2015 to July 2016, 20 patients with moderate and severe earwheel skin defects were collected and treated in plastic surgery and burn surgery, first affiliated Hospital of Shanxi Medical University. (tumor, etc.), it was repaired by curved rectangular propelling flap behind the ear, debridement preparation / mass excision of ear ring defect area in one stage and pedicle reconstruction of ear wheel broken in the second stage after 6 weeks of stump ear implantation. The posterior ear donor flap was repaired with papillary rectangular sliding flap. All operations were performed by the same surgeon and followed up for 6-15 months. POSAS scale was used to evaluate the effect of retroauricular curved rectangular sliding flap for repairing severe earwheel skin defect. The measurement data were expressed as mean 鹵standard deviation, the counting data were expressed as percentage, and the satisfaction between the patient and the observer was measured by chi-square test. All data were counted by SPSS17.0for windows. The test level is 0.05.3. Results (1) Direct observation: no infection was found in the 20 patients, the wound was reopened, the pedicle was broken and the gliding flap survived well. Among them, 18 cases had good shape, smooth contour and thickness of the affected lateral ear. The color and luster were similar to those of the surrounding skin, the scar hyperplasia in the posterior mastoid area was not obvious, and there was no obvious concave and convex sensation in the junction. In one case, the lateral ear was slightly bloated and the lines were not smooth enough after operation. The results of sx 鹵(2) POSAS scale showed that the patients' satisfaction after operation was 85 and the observer's satisfaction was 90. There was no significant difference between the patient and the observer. Conclusion: the reconstruction of moderate and severe earwheel skin defect with rectangular sliding-forward flap behind the ear is simple, the appearance is good, the visual difference is small, the scar of donor flap area is concealed, and it is worth popularizing and applying in clinic.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R622

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 施曉曉;湯婛;;瘢痕評估量表的文獻(xiàn)復(fù)習(xí)[J];中國皮膚性病學(xué)雜志;2014年05期

2 劉暾;錢瑾;阮晶晶;章慶國;周栩;韓雪峰;胡金天;;耳后推進(jìn)皮瓣結(jié)合同側(cè)耳甲腔軟骨移植修復(fù)耳輪全層缺損[J];中國美容整形外科雜志;2014年04期

3 田蒙;劉暾;韓雪峰;;隱耳畸形的一種治療方法-同時矯正耳廓埋藏畸形和軟骨畸形[J];中國美容醫(yī)學(xué);2012年12期

4 于曉波;蔣海越;莊洪興;潘博;趙延勇;劉磊;;耳后擴(kuò)張皮瓣聯(lián)合自體肋軟骨移植修復(fù)耳輪部分缺損[J];中國美容醫(yī)學(xué);2011年03期

5 張晉光;何樂人;莊洪興;;顱耳溝皮管修復(fù)耳輪部分缺損[J];中國美容醫(yī)學(xué);2010年06期

6 劉勛;李勇強(qiáng);;外傷性耳廓缺損的治療體會[J];泰山醫(yī)學(xué)院學(xué)報;2009年01期

7 王丹茹;章一新;錢云良;方建藺;楊軍;張余光;;應(yīng)用顳淺動脈耳后支皮瓣修復(fù)上耳輪缺損[J];上海交通大學(xué)學(xué)報(醫(yī)學(xué)版);2006年09期

8 袁兆昌;胡海波;王貝斌;賀應(yīng)梅;;改良耳后皮瓣修復(fù)耳廓缺損[J];中國修復(fù)重建外科雜志;2006年07期

9 朱曉青;田蓓;楊文利;魏文斌;翁乃清;王蘭;;球后注射山莨菪堿對眼前部缺血性視神經(jīng)病變血流動力學(xué)的影響[J];中華眼科雜志;2006年07期

10 熊偉;蘭華;梁玉霞;;乳突區(qū)推進(jìn)皮瓣在耳廓整形中的應(yīng)用[J];兵團(tuán)醫(yī)學(xué);2005年04期

，

本文編號：2172046