应用削除及磨削法治疗体表先天性巨痣疗效分析

目的探索应用削除或磨削法治疗成人体表先天性巨痣的操作与效果。方法综合先期进行的病理学检查结果、病变具体位置及患者的治疗心理预期等相关因素后，使用滚轴取皮刀切取刃厚或中厚皮片，或者使用高速的“西瓜”磨头磨削肿物浅层病变的方法治疗巨痣，治疗区保持在湿润状态下愈合，治疗按部位分1～2次进行，共治疗10例。结果10例中5例患者取得较为理想的效果，肤色接近正常，病理学检查未发现痣细胞明显残留，4例明显改善，1例有所复发，多数治疗效果均达到患者的心理预期。结论削除或磨削法对曾用其他方法治疗效果不佳或须付出较大代价的体表先天性巨痣有明显的实用效果，特别是由于综合考虑了多种相关因素，有利于在治疗效果与治疗代价之间取得较好的平衡，值得在临床上加以推广。

Tangential excision and dermabrasion in treatment of superficial giant congenital melanocytic nevus

Objective Present treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.Results One to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.Conclusions The two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.