摘要
目的探讨应用异种脱细胞真皮基质与自体游离薄层皮片修复先天性外中耳畸形患者新建耳道的皮肤缺损的方法与疗效。方法回顾性分析首都医科大学附属北京同仁医院2013年1月至2015年4月收治的68例先天性骨性外耳道狭窄或闭锁,行骨性外耳道重建术患者的临床资料,应用异种脱细胞真皮基质修复新建耳道皮肤缺损的32例患者设为实验组,使用自体游离薄层皮片修复新建耳道皮肤缺损的36例患者设为对照组。统计对比两组移植物的成活率及耳道完全上皮化时间,并对比两组重建耳道的皮肤形态差异。结果随访3个月,所有患者均未出现移植物脱落现象以及排斥反应,两组移植物成活率均为100%。实验组平均上皮化时间(4.3±1.0)周,对照组平均上皮化时间(2.4±0.7)周,两组差异有统计学意义(t=8.51,P<0.05)。两组移植物上皮化后表面光滑,外形相似,但与实验组比,对照组皮片较薄,弹性略差。结论异种脱细胞真皮基质可替代自体游离薄层皮片修复耳道重建术后的皮肤缺损,能够有效地促进创面愈合,具有一定的临床实用价值。
Objective Discuss the application of heterogeneous aeellular dermal matrix and autologous free thin skin graft to repair skin defect after reseonstrusfion of external auditery canal. Methods A retrospective analysis of 68 cases of congenital external auditory canal steuosis or atresia were selected as the research object in Tongren Hospital, Capital Medical University from January 2013 to April 2015. In the experimental group, 32 cases used heterogeneous aceliular dermal matrix to repair the skin defect of the external auditory canal. In the control group, 36 cases repaired the skin defect of the external auditory canal with autologous free thin skin flap. The survival rate of the two groups and the complete epithelial time of the external auditory canal were statistically compared. And the differences of reconstructed skin＇s morphology were compared too. Results Followed up for 3 months, all patients had no any graft loss and rejection. The survival of graft of the two groups were 100%. The average time of the epithelium in group was 4.3±1.0 weeks, while the control group was 2.4±0.7 weeks. The average time of the epithelium between two groups was statistically significant difference （ t = 8.51, P 〈 0.05 ）. Both skin of the two group were smooth. The skin of the control group was thin and its elasticity was slightly worse. Conclusion Heterogeneous acellular dermal matrix can replace the autologous free thin flap to repair skin defect after the resconstruction of external auditory canal, which can effectively promote wound healing and reduce damage, has a certain clinical practical value.
出处
《中华损伤与修复杂志（电子版）》
CAS
2015年第4期30-33,共4页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
首都临床特色资助研究(Z121107001012048)
关键词
生物敷料
修复外科手术
耳道
创伤和损伤
上皮
Biological dressings
Reconstructive surgical procedures
Ear canal
Wounds andinjuries
Epithelium
作者简介
马晓波，医学博士，主治医师。现工作于北京同仁医院耳鼻咽喉头颈外科，专注于各种耳科疑难病症的诊疗，围绕先天性外中耳畸形、慢性化脓性中耳炎、重度感音神经聋，面神经麻痹，听神经瘤等外、中、内耳疾病开展了大量的临床工作。
通讯作者：赵守琴，Email：shouqinzhao@163．com
