78例儿童先天性面部色素痣分期切除结合外扩张的美容效果

Cosmetic effects of staged resection of congenital facial nevus combined with external dilatation in 78 children

目的探讨分期切除结合外扩张在儿童先天性面部色素痣临床治疗中的效果。方法选取2019年1月至12月就诊的先天性面部色素痣患儿78例的临床资料进行回顾性分析。根据患儿治疗方式分为4组:患者只进行一期切除术治疗(A组,16例);患者只进行分期切除术治疗(B组,14例);患者行一期切除术结合外扩张治疗(C组,27例);患者行分期切除术结合外扩张治疗(D组,21例)。采用独立t检验统计分析不同组间瘢痕面积与原皮损面积比值及最终瘢痕宽度的差异,描述性分析对患儿面部不同分区的瘢痕平均宽度进行对比。结果(1)瘢痕面积占皮损面积比例分析结果显示,B组比A组减小程度明显(P=0.02),D组比C组减小程度明显(P<0.001);(2)最终的瘢痕宽度分析结果显示,C组比A组宽度小(P<0.001),D组比B组宽度小(P<0.001);(3)面部不同分区的平均瘢痕宽度对比结果显示,D组瘢痕宽度最小。结论分期切除结合外扩张治疗儿童先天性面部色素痣,可取得较好的美容效果,值得临床推广应用。

Objective To explore the effects of staged excision combined with external dilatation in children with congenital facial nevus.Methods A retrospective analysis was performed on the clinical data of 78 children with congenital facial nevus who visited hospital in 2019.The children were divided into 4 groups according to the treatment methods:one-stage excision group(group A,n=16),staged excision group(group B,n=14),one-stage excision combined with external dilatation group(group C,n=27),staged excision combined with external dilatation(group D,n=21).The ratio of scar area to original skin lesion area and the differences in final scar width among different groups were analyzed with independent t-test,the average scar widths in different facial regions were compared with descriptive analysis.Results(1)Analysis of the ratio of scar area to original skin lesion area showed that group B had more significant reduction than group A(P=0.02),and group D had more significant reduction than group C(P<0.001).(2)Group C had smaller width of scar than group A(P<0.001),and group D had smaller width of scar than group B(P<0.001).(3)The average scar width in group D was the smallest.Conclusion Staged excision combined with external dilatation can achieve good cosmetic results in the treatment of congenital facial nevus and is worthy of clinical application.