打孔同步植入毛囊单位法对男性型脱发的修复效果观察

Prosthetic effect of follicular-unit grafting with simultaneous puncturing-and-seeding technique on male-pattern baldness

目的探索一种损伤小、出血少、打孔与植入同步的毛发移植方法用于修复男性型脱发。方法选择2001年9月-2008年8月收治的391例男性型脱发患者,根据移植量的需求,局麻下切取枕、颞部优势供区内一定数量的含有完整毛囊的头皮组织,4倍立体显微镜下分割成含不同数量毛发的系列毛囊单位移植物,然后以相应孔径的注射器针具作为打孔工具,以边打孔边植入的方式(即打孔、植入同步完成)将制备的毛囊单位移植物植入到男性的额顶部脱发区。术后随访8个月以上,并随机选择10例患者的10个毛发移植受区,以1cm2为计数面积,计算手术后移植毛发的成活率。结果应用打孔植入同步的方法修复后,391例患者的毛发生长方向和分布自然,移植区域头皮无瘢痕,表面平整,无炎症表现。移植的毛发单位密度为15～28个/cm2,移植毛发的根数为36～71根/cm2,平均成活率为97.1%。结论打孔植入同步的毛囊单位移植技术手术创伤小、出血少,术后毛发生长外观自然,并发症少,是较理想的男性型脱发治疗手段。

Objective To explore a new hair grafting method with slight injury and less bleeding with simultaneous puncturing-and-seeding for treatment of male-pattern baldness.Methods Three hundred and ninety-one consecutive male pattern baldness（Norwood III-IV） patients from Sep.2001to Aug.2008were involved in present study.Under local anesthesia,the scalp containing certain amount of hair follicles was harvested from occipital-temporal region according to the requirement of grafting quantity,then the hair grafts containing a series of follicular unit were made under a 4×power anatomical microscope.Thereafter,the grafts were individually implanted in the balding recipient site,parallel to the original hair directions,by using a simultaneous puncturing-and-seeding technique,in which the graft was seeded into a needle hole right after the punctured needle was withdrawn.All of the patients were followed up longer than 8months,and 10recipient regions （sized 1cm^2）of 10patients were randomly selected to calculate the survival rate of transplanted hairs.Results All the 391patients were treated by the above-mentioned method.The grafted hairs grew in desired directions,no scar or inflammatory response was found in grafted area.The grafted follicular unit density was 15-28/cm^2,while the grafted hair density was 36-71/cm^2,with an average survival rate of 97.1%.Conclusion The follicular-unit grafting with simultaneous puncturing-and-seeding is a technique with slight injury,less bleeding and complications, resulting in natural hair growth direction,and is an ideal therapeutic technique for male-pattern baldness.