可调控眉毛密度的眉再造术同期治疗瘢痕性秃发的临床护理(1)
[摘要]目的：探索专项护理在眉再造同期治疗瘢痕性秃发术中的应用效果。方法：根据手术过程分两期进行专项临床护理。扩张器一期置入术后进行扩张器相关专项护理，严密监测扩张注水情况，密切观察扩张部位，防止扩张皮瓣坏死或感染;眉再造和瘢痕性秃发修复二期术后密切观察再造眉毛头皮条的颜色，避免静脉回流不畅发生。结果：本组12例患者进行了眉再造的全方位密切护理，岛状头皮瓣全部存活，头皮瘢痕全部修复，无一例皮瓣坏死。随访6～24个月，再造眉毛毛发密度与健侧非常接近，眉形自然逼真，手术效果满意。结论：在可调控眉毛密度的眉再造同期治疗瘢痕性秃发术中进行全方位护理是手术成功的重要保障。
[关键词]瘢痕性秃发;可调控眉毛;眉再造;扩张;专项护理;瘢痕
Abstract： Objective To explore the effect of special nursing in the operation of eyebrow reconstruction and the treatment of cicatricial alopecia at the same time. Methods According to the operation process， special nursing was carried out in two phases. After the first stage placement of expander， special nursing should be carried out for the expander， the water injection of expander should be monitored closely， and the expansion site should be observed closely to prevent the expansion flap from necrosis or infection. After two stages of eyebrow reconstruction and cicatricial alopecia repair， the color of scalp strip of reconstructed eyebrow should be closely observed to avoid the occurrence of poor venous return. Results Twelve patients underwent this method to reconstruct the eyebrows. All the island scalp flaps survived and no flap necrosis occurred. After 6-24 months of follow-up， the hair density of the reconstructed eyebrows was very close to the healthy side， without excessive thickening and excessive sparseness. The bald hair was completely repaired， and the sutures are small and the hair can be covered. The patients were all satisfied with the surgical results. Conclusion It is an important guarantee for the success of the operation to carry out all-round nursing during the operation of eyebrow reconstruction with adjustable eyebrow concentration and the treatment of cicatricial alopecia at the same time.
Key words： cicatricial alopecia; adjustable eyebrow; eyebrow reconstruction; expansion; special nursing; scar
瘢痕性禿发伴随眉毛缺损或眉毛缺失是头面部烧伤后较为常见的并发症[1]。应用扩张器治疗瘢痕性秃发已经是很常规的方法，效果也很显著。对于眉毛缺损的治疗，目前有一些眉毛再造的方法，其中常见的术式有游离头皮条移植或单株种植，也有带颞浅动脉为蒂的头皮瓣做眉再造。前者常因转移过程中血液供应不足使再造眉毛稀疏，后者又因血供过于良好而使再造眉毛尤为浓密不自然。武汉大学附属同仁医院整形外科采用扩张皮瓣独立调控再造眉毛的密度，使再造眉毛力求达到同健侧眉形基本无差异的效果，同时同期手术修复瘢痕性秃发的新方法。护理团队根据新的手术方式实行全程专项护理，从术前护理、第一期手术后护理、扩张注水期皮瓣毛发密度的观察及护理、第二期手术后护理等进行详细护理，适时个性化调整护理方案治疗与处置，对保障手术效果起到良好作用，现报道如下。
1 资料和方法
1.1 一般资料：2012年10月至2016年7月，笔者科室共收治单侧眉毛缺失伴瘢痕性秃发患者12例，男性7例，女性5例，年龄18～37岁，秃发面积5cm×6cm～12cm×10cm，部位分布为顶部、枕部、颞部。
1.2 手术方法：手术分两期进行。
1.2.1 第一期手术：术前用多普勒血流探测器在眉缺失患侧探测颞浅动脉走形，在该侧颞部头皮下埋置100～200ml大小的扩张器一枚。瘢痕性秃发四周可根据秃发面积大小增加埋置扩张器，以确保扩张后头皮能覆盖切除后瘢痕创面。, http://www.100md.com(胡梦)
[关键词]瘢痕性秃发;可调控眉毛;眉再造;扩张;专项护理;瘢痕
Abstract： Objective To explore the effect of special nursing in the operation of eyebrow reconstruction and the treatment of cicatricial alopecia at the same time. Methods According to the operation process， special nursing was carried out in two phases. After the first stage placement of expander， special nursing should be carried out for the expander， the water injection of expander should be monitored closely， and the expansion site should be observed closely to prevent the expansion flap from necrosis or infection. After two stages of eyebrow reconstruction and cicatricial alopecia repair， the color of scalp strip of reconstructed eyebrow should be closely observed to avoid the occurrence of poor venous return. Results Twelve patients underwent this method to reconstruct the eyebrows. All the island scalp flaps survived and no flap necrosis occurred. After 6-24 months of follow-up， the hair density of the reconstructed eyebrows was very close to the healthy side， without excessive thickening and excessive sparseness. The bald hair was completely repaired， and the sutures are small and the hair can be covered. The patients were all satisfied with the surgical results. Conclusion It is an important guarantee for the success of the operation to carry out all-round nursing during the operation of eyebrow reconstruction with adjustable eyebrow concentration and the treatment of cicatricial alopecia at the same time.
Key words： cicatricial alopecia; adjustable eyebrow; eyebrow reconstruction; expansion; special nursing; scar
瘢痕性禿发伴随眉毛缺损或眉毛缺失是头面部烧伤后较为常见的并发症[1]。应用扩张器治疗瘢痕性秃发已经是很常规的方法，效果也很显著。对于眉毛缺损的治疗，目前有一些眉毛再造的方法，其中常见的术式有游离头皮条移植或单株种植，也有带颞浅动脉为蒂的头皮瓣做眉再造。前者常因转移过程中血液供应不足使再造眉毛稀疏，后者又因血供过于良好而使再造眉毛尤为浓密不自然。武汉大学附属同仁医院整形外科采用扩张皮瓣独立调控再造眉毛的密度，使再造眉毛力求达到同健侧眉形基本无差异的效果，同时同期手术修复瘢痕性秃发的新方法。护理团队根据新的手术方式实行全程专项护理，从术前护理、第一期手术后护理、扩张注水期皮瓣毛发密度的观察及护理、第二期手术后护理等进行详细护理，适时个性化调整护理方案治疗与处置，对保障手术效果起到良好作用，现报道如下。
1 资料和方法
1.1 一般资料：2012年10月至2016年7月，笔者科室共收治单侧眉毛缺失伴瘢痕性秃发患者12例，男性7例，女性5例，年龄18～37岁，秃发面积5cm×6cm～12cm×10cm，部位分布为顶部、枕部、颞部。
1.2 手术方法：手术分两期进行。
1.2.1 第一期手术：术前用多普勒血流探测器在眉缺失患侧探测颞浅动脉走形，在该侧颞部头皮下埋置100～200ml大小的扩张器一枚。瘢痕性秃发四周可根据秃发面积大小增加埋置扩张器，以确保扩张后头皮能覆盖切除后瘢痕创面。, http://www.100md.com(胡梦)
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