头发移植术后并发动静脉瘘的治疗

Therapy of arteriovenous fistula following hair transplantation

头发移植是以男性秃发患者为主的最常见的美容手术 ,其中打孔自体皮片移植是最简单最有效的方法 ,并发症少见报道。文献回顾目前国外有 9例头发移植术后发生了动静脉瘘 (ArteriovenousFistula简称AVF)。其症状为在术后数周至数月在头皮任何区域出现的一个或数个异常隆起的肿块 ,有搏动、杂音等症状 ,甚至会引起出血、头皮坏死。有时有局部疼痛或头痛症状。文献中多见为发生于受区的AVF。本文报道了我科近十年来 2 0 0 0多次10 0 0多名患者头发移植术后发生的 5例AVF ,其中 4例发生于颞浅动静脉区 ,1例发生于枕动静脉区 ,提示AVF在较粗动静脉同时受损时容易发生。发生年龄集中于 3 0岁左右 ,提示青年好发。讨论了AVF的形成 ,治疗方式 ,尤其是对AVF的环扎治疗 ,它能快速止血 ,对应急处理特别有效。本文还讨论了如何尽可能减少AVF的发生。

Hair transplantation is one of the most common cosmetic surgery performed on man. Punch grafts and minigrafts are the simple and effective methods. The procedure is associated with relatively few complications. Nine cases of arteriovenous fistula (AVF) have been reported in the literatures oversea. The symptoms are occured several weeks or months after transplantation, an abnormal mass may appear anywhere on the scalp with pulsation, bruit and hemorrhage etc. but most of them are in the recipient area. Our union have made hair transplantation operation on more than 1?000 cases (more than 2?000 times) during the late 10 years. Five cases of AVF following the procedure were reported here. Four of them appeared in the temporal A-V area, and another one was in the occipital A-V area. It implies that AVF are easily to occur when some large artery and vein are injured simultaneously. The age of the five cases were about 30 years old, focusing on the young. We discussed the formation of AVF, therapeutic methods, especially cyclic ligation. It is very effective on emergency. We also discussed how to avoid such serious complication.