瘢痕性秃发手术方法选择及临床疗效评估

Operational options and outcomes evaluation in cicatricial alopecia

目的总结瘢痕性秃发患者手术治疗的临床经验，探讨临床手术治疗瘢痕性秃发的最佳策略。方法回顾性分析2012年1月至2016年12月间的80例瘢痕性秃发患者手术治疗的临床资料，收集患者临床一般资料，记录手术方法及相关不良事件，术后1周、1、3、6个月和1～2年复诊。按照非常满意、满意、不满意和无效4级标准以问卷的方式进行疗效评定。结果本组80例瘢痕性秃发患者，40例采用扩张皮瓣＋毛囊单位提取移植术（FUE），10例采用瘢痕部分切除＋FUE修复，30例直接采用FUE修复。20例一期手术完成治疗，60例均经二期治疗。一期患者术后非常满意者占70％，满意者占30％。二期患者术后非常满意者占85％，满意者占15％。结论瘢痕性秃发需要综合手术治疗，FUE是扩张器技术之后的又一利器，联合扩张器治疗大面积瘢痕性秃发的临床效果优于单一方法治疗组。

Objective To summarize the operational experience and explore the best surgery strategy in cicatricial alopecia. Methods Clinical date of 80 cases of cicatricial alopecia during January 2012 to December 2016 were analyzed retrospectively. The operation methods and related adverse events were recorded. Patients were followed-up on the postoperative 1 week, 1 month, 3 months, 5 months and l -2 years. The outcomes were evaluated by a 4-levels questionnaire： very satisfied, satisfied, not satisfied, and no effect. Results Forty cases were operated with expanded skin flap ＋ Follicular unit extraction （FUE） transplantation, 10 cases with scar resection ＋ FUE repair, and 30 cases only with FUE. Twenty eases were completed treatment with single-stage surgical operation, and 60 cases with two-stage surgical operation. A percentage （70%） of patients was very satisfied and 30% were satisfied after one-stage surgical operation. A percentage （85%） of patients was very satisfied and 15% were satisfied after two-stage surgical opera- tion. Conclusions The cicatricial alopecia needs comprehensive surgical treatment. FUE is a best addi- tional operation technology. The effect of combined treatment is better than single therapy method in large area cicatricial alopecia.