毛囊单位提取移植术治疗瘢痕性秃发的临床应用和疗效观察

Clinical application and curative effect observation of follicular unit extraction and transplantation in the treatment of cicatricial alopecia

目的观察毛囊单位提取(FUE)移植术治疗瘢痕性毛发缺失的临床效果。方法采用回顾性队列研究方法。2012年1月—2018年1月,西安医学院第一附属医院接诊符合入选标准的瘢痕性秃发患者56例[男36例、女20例,年龄(25±9)岁,秃发面积占整个头皮的1%-30%],对患者行FUE移植术治疗。治疗过程为术前设计、提取和制备毛囊单位、受区打孔、毛发种植。随访时计算毛发成活率、成活毛发密度,观察毛发生长情况及并发症,同时按照非常满意、满意、不满意和无效4级标准以问卷的方式对患者的植发效果进行疗效评定。结果经过9-24个月随访,56例患者毛发成活率为(70±9)%,成活毛发密度为(35±8)根/cm^(2)。Ⅰ期术后疗效评定中,非常满意者34例(60.7%)、满意者16例(28.6%)、6例(10.7%)患者认为治疗有效但是不满意。不满意的6例患者和满意的16例患者进行了Ⅱ期移植手术,Ⅱ期术后疗效评定中,非常满意者19例(86.4%)、满意者3例(13.6%)。所有患者未进行Ⅲ期手术。移植毛发生长自然,所有病例术后均未出现严重并发症。结论FUE移植术能有效地治疗并改善瘢痕性秃发,且创伤小、并发症少、供区不遗留瘢痕、术后恢复快,值得在临床推广。

Objective To observe the clinical effect of treatment with follicular unit extraction(FUE)and transplantation in treating cicatricial alopecia.Methods The retrospective cohort study was conducted.From January 2012 to January 2018,56 patients(36 males and 20 females,aged(25±9)years,1%to 30%alopecia area of the whole scalp area)who met the inclusion criteria visited the outpatient department of the First Affiliated Hospital of Xi'an Medical University.They were treated with FUE transplantation.The procedure of treatment was performed through the preoperative planning,follicular extraction,follicular preparation,punching recipient site and hair transplantation.The survival rate of hair and density of survived hair were calculated,hair growth and complication were observed.The evaluation was conducted through questionnaire survey by 4 levels:very satisfied,satisfied,not satisfied,and not at all satisfied with effects.Results After a follow-up of 9 to 24 months,the survival rate of hair in 56 patients was(70±9)%,and the density of survived hair was(35±8)roots/cm^(2).In the evaluation of the curative effect after the first stage surgery,34 cases(60.7%)were very satisfied,16 cases(28.6%)were satisfied,and 6 cases(10.7%)thought the treatment was effective but not satisfied.Six unsatisfactory patients and 16 satisfactory patients underwent the second-stage transplantation,with 19(86.4%)of them being very satisfied and 3 cases(13.6%)satisfied after the second-stage operation.None of the patients underwent the third-stage surgery.The transplanted hairs grew naturally,and there were no serious complications in all cases.Conclusions FUE transplantation can effectively treat and improve cicatricial alopecia with less trauma,fewer complication,no scar in the donor site and rapid post-operative recovery,so it is worthy of clinical promotion.