分次切除缝合与皮肤扩张术治疗儿童面部大面积黑色素痣的应用比较

Comparison of the Application of Sequential Resection and Suture andSkin Expansion in the Treatment of Large Area Melanoma in Children

目的:比较分次切除缝合与皮肤扩张术治疗儿童面部大面积黑色素痣的临床效果。方法:回顾性分析某院烧伤整形科2016年1月~2019年1月收治的62例面部大面积黑色素痣患儿临床资料,将采用皮肤扩张术治疗的患儿归为A组(32例),将采用分次切除缝合的患儿归为B组(30例),对比两组手术治疗效果(美观度、黑色素痣清除、满意度)以及术后不良事件发生情况。结果:两组黑色素痣清除及满意度评分比较,差异无统计学意义(P>0.05);相较B组,A组美观度评分较高,差异有统计学意义(P<0.05);两组术后不良事件发生率比较,差异无统计学意义(P>0.05)。结论:面部大面积黑色素痣患儿采用皮肤扩张术与分次切除缝合治疗均可取得显著效果,均具有较高黑色素痣清除率,且安全性较高,但皮肤扩张术治疗美观度较高,临床实际应用时应依据患儿实际情况灵活选择治疗方式。

Objective:To compare the clinical effects of sequential resection and suture and skin expansion in the treatment of large-αrea melanoma on the face of children.Methods:A retrospective analysis of the clinical data of 62 children with large-αrea melanoma on the face admitted to a hospital from January 2016 to January 2019 was conducted,the children treated with skin expansion were classified as group A(32 cases),and the children treated with sequential resection and suture were classified as group B(30 cases).The surgical treatment effects(aesthetic degree,melanoma removal,satisfaction degree)and the occurrence of postoperative adverse events were compared between the two groups.Results:There was no statistically significant difference in melanoma removal and satisfaction scores between the two groups(P>0.05);Compared with group B,group A had a higher aesthetic score,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the incidence of postoperative adverse events(P>0.05).Conclusion:Both skin expansion and sequential resection and suture for children with large-αrea melanoma can achieve significant results,with higher removal rate of melanocytic nevus and safety.However,skin expansion is more aesthetically pleasing,and in actual application,the treatment method should be flexibly selected according to the actual situation of the child.