面颈部皮脂腺囊肿的美容性治疗临床探讨

The clinical investigation of aesthetic treatment of face and neck sebaceous cyst

目的:探讨面颈部皮脂腺囊肿的美容性治疗临床策略,力求在根治的基础上尽量减少瘢痕的形成。方法:依据病史及临床体征将面颈部皮脂腺囊肿分为单纯性皮脂腺囊肿、粘连性皮脂腺囊肿和感染性皮脂腺囊肿,其中感染性皮脂腺囊肿根据临床表现再区分,结合囊肿的大小,分别采取不同的治疗方案:无切口减压摘除术、小切口微创摘除术、抗生素治疗延期手术法、切开引流刮治后缝合法。治疗后随访1年,观察指标为复发率高低及局部瘢痕形成情况。结果:252例单纯性皮脂腺囊肿患者,电话随访1年,均无复发,其中148例获得复诊随访,局部无明显手术痕迹。47例粘连性皮脂腺囊肿患者电话随访1年,2例复发,再次采用小切口微创摘除术治愈。47例中28例获得复诊随访,切口瘢痕不明显。52例感染性皮脂腺囊肿患者电话随访1年,2例复发,均为皮肤红肿处有明显液化而应用切开引流刮治后缝合法治疗的患者,再次采用小切口微创摘除术治愈。其中28例应用抗生素治疗延期手术法的患者中有4例在抗生素治疗的过程中局部液化积脓,改用切开引流刮治后缝合法治愈。52例中29例获得复诊随访,切口瘢痕不明显。结论:依据病史及临床体征将面颈部皮脂腺囊肿分为单纯性皮脂腺囊肿、粘连性皮脂腺囊肿和感染性皮脂腺囊肿,分别采用无切口减压摘除术、小切口微创摘除术、抗生素治疗延期手术法、切开引流刮治后缝合法,能够达到最佳的美容性治疗效果,患者满意度高。

Objective The aim of this study was to explore the clinical strategy of aesthetic treatment of face and necksebaceous cyst and to minimize scar formation on the basis of a radical cure of sebaceous cyst. Methods According to medicalhistory and clinical signs, face and neck sebaceous cysts were divided into simple sebaceous cyst, adhesive sebaceous cyst andinfective sebaceous cyst (which was further differentiated by clinical manifestations). Different treatment options were takenwith respect to the cyst sizes: decompression enucleation without incision,minimally invasive enucleation with small incision,antibiotic treatment and delayed operation, or suturing after incision, drainage and scaling. All patients were followed up over1 year. Postoperative recurrence and postoperative scar were recorded. Results No recurrence was found in 252 patients withsimple sebaceous cyst, who were followed up by telephone for one year. Among those patients, 148 cases received followupvisit; and no obvious operation scar was observed. Of 47 patients with adhesive sebaceous cyst, who were followed up bytelephone for one year, there were 2 recurrence cases. Both patients were cured by a second minimally-invasive enucleation.Among 47 patients, 28 cases received follow-up visit; and incision scar was not noticeable. Of 52 patients with infectivesebaceous cyst, who were followed up by telephone for one year, there were 2 recurrence cases. These two patients originallyhad skin irritation with marked liquefaction and underwent the procedure of suturing after incision, drainage and scaling. Bothpatients were cured by a second minimally-invasive enucleation. Among 28 cases that received antibiotic treatment and delayedoperation, local liquefaction and empyema were observed in 4 cases. They were all cured after switching to the method ofsuturing after incision, drainage and scaling. Among 52 patients, 29 cases received follow-up visit; and incision scar was notobvious. Conclusion Face and neck sebaceous cysts, in accordance with medical history and clinical signs, were categorizedinto simple sebaceous cyst, adhesive sebaceous cyst and infective sebaceous cyst. Based on the specific category, differenttreatment option was chosen respectively: decompression enucleation without incision,minimally invasive enucleation withsmall incision, antibiotic treatment and delayed operation, or suturing after incision, drainage and scaling. Thus, the bestaesthetic treatment effect could be achieved; and the patient satisfaction was high.