瘢痕上自体毛发移植782例

目的 运用自体毛发移植术将头发毛胚在头部瘢痕上进行移植。观察在瘢痕上头发移植的特点及移植后的效果。方法 1998～2002年对782例因不同原因引起头部瘢痕的患者运用自体毛发移植术进行修复。结果 移植的头发均生长良好。但因形成瘢痕原因的不同，所造成的瘢痕深度的不同和血运状态的不同，引起头发生长的速度及状态亦不同。结论 自体毛发移植术可以应用于头部瘢痕性脱发的修复，对感染、烫伤及火轻中度烧伤而引起的瘢痕均可实施手术，且术后效果均较理想；对于头皮撕脱伤、电击伤及火深度烧伤者，手术后，头发生长速度较慢。     

自体单位毛发移植术临床应用

目的:探索应用自体单位毛发移植(Follicular unit transplantation,FUT)治疗脂溢性脱发及瘢痕性秃发的临床效果。方法:后枕部取与种植数量吻合的条形皮瓣,根据需要制备成单体毛胚(1～4根头发),把毛胚植入脱发区域相应孔内,治疗脂溢性脱发47例,瘢痕性脱发20例,瘢痕性眉毛缺失6例。结果:移植胚成活率脂溢性脱发为95%以上,瘢痕性脱发为70%以上,瘢痕性眉毛缺失为70%以上。结论:自体单位毛发移植可以较好的治疗脂溢性脱发及瘢痕性秃发,以前者治疗效果更佳。     

高密度毛发移植术在瘢痕性脱发治疗中的应用

目的 探讨高密度毛发移植术在瘢痕性脱发修复中的疗效及其特点.方法 首先根据脱发区的面积及毛发的移植密度计算出移植毛囊的单位数;然后以患者的枕后部为供区,切取优势的头皮条,采用显微分割的方法将其制成保留正常解剖结构的毛囊单位后植入脱发区.自2005年1月至2010年12月,对76例瘢痕性脱发患者行高密度毛发移植术.结果 术后随访76例患者6～18个月,其中脱发区被完全覆盖者36例,为优;基本覆盖者24例,为良;毛发的密度较低,仍有部分脱发区外露者13例,为可;头皮瘢痕明显外露者3例,为差.移植后的毛发外形自然,患者满意.有2例患者发生表皮样囊肿,经局部处理后愈合.结论 高密度毛发移植治疗瘢痕性脱发具有创伤小、恢复快、移植密度和成活率高、毛发生长形态自然等特点,术后效果满意,值得推广使用.     

头皮扩张与自体头发移植术治疗瘢痕性秃发

目的：探讨一种有效治疗瘢痕性秃发的方法。方法：1993－1998年,收治多部位或大面积瘢痕性秃发21例,根据秃发部和面积的不同,对同一患者的瘢痕性秃发分别采用头发扩张与自体头发移植术（带毛囊皮条移植）进行治疗,共安放皮肤扩张器34枚,修复秃发的最大面积为340cm2,结果：无论秃发区面积的大小,或是鬓角,发际等特殊部位的秃发,术后创面愈合良好,秃发区均得较满意的修复,1个月后移植的带毛囊皮条基本成活,并可见毛发生长,本组术后发生扩张器外露1例,扩张失败1例,均及时取出处理,另有2例头发生长方向改变。结论：头皮扩张与自体头发移植术联合应用,是治疗多部位或大面积瘢痕性秃发较 理想的方法。     

自体微小及显微毛发移植术治疗雄激素源性脱发

目的 探索应用自体微小及显微毛发移植治疗雄激素源性脱发的新技术.方法 选择头部生长有健康浓密毛发的头皮为供区,制备成微小及显微毛发移植物,植入脱发区域.结果 自2002年2月至2008年6月,用此方法治疗雄激素源性脱发患者共425例.移植的毛发均生长密集、发质良好,毛流自然,平均成活率达95%,外观满意.结论 自体微小及显微毛发移植物结合使用,可使移植区域毛发过渡自然,术后毛发生长密集.发质良好,是治疗雄激素源性脱发较好的手术方法.     

国人自体头发移植术的研究

自１９８８年９月至１９９２年１２月，共已施行９８０次自体头皮打孔皮片头发移植术，主要用于供区发源充沛的脂溢性秃发和瘢痕秃发者３９５例。根据国人的头发数量较白种人约少１／３，毛干呈直线型，以及头发与头皮色泽反差大等特点，采用了Ｌ形排列移植、圆皮片间插入半圆皮片，术后头皮文身及烫发等相应措施以提高疗效。并认为成人发适宜头发移植、而儿童则更适宜头皮扩张术。     

国人自体头发移植术的研究

自１９８８年９月至１９９２年１２月，共已施行９８０次自体头皮打孔皮片头发移植术，主要用于供区发源充沛的脂溢性秃发和瘢痕性秃发者３９５例。根据国人的头发数量较白种人约少１／３，毛干呈直线型，以及头发与头皮色泽反差大等特点，采用了Ｌ形排列移植、圆皮片间插入半圆皮片，术后头皮文身及烫发等相应措施以提高疗效，并认为成人秃发适宜头发移植，而儿童则更适宜头皮扩张术。     

国人自体头发移植术的研究

自1988年9月至1992年12月,共已施行980次自体头皮打孔皮片头发移植术,主要用于供区发源充沛的脂溢性秃发和瘢痕性秃发者395例。根据国人的头发数量较白种人约少1/3,毛干呈直线型,以及头发与头皮色泽反差大等特点,采用了L形排列移植、圆皮片间插入半圆皮片,术后头皮文身及烫发等相应措施以提高疗效。并认为成人秃发适宜头发移植,而儿童则更适宜头皮扩张术。     

高密度自体毛发移植治疗脂溢性秃发的疗效观察

目的 探讨应用高密度显微外科毛发移植技术,综合移植多种微小型毛胚,治疗脂溢性秃发的临床效果.方法 切取患者头发生长浓密的枕、颞部头皮作为毛发移植供体,5倍专用手术显微镜下分离毛囊,制成多种微小移植毛胚,以三棱针、微型刀片和卵圆形打孔器在受区打孔,用显微外科移植镊,由前向后顺序将移植毛胚植入受区孔隙,术后定期随访.结果 32例脂溢性秃发,移植毛发的平均成活率为90%,Ⅰ期手术后患者满意度为81%,6例不满意患者行Ⅱ期手术后均达到了满意的治疗效果.随访12～24个月,毛发生长自然、密集,发质良好无脱落.结论 应用高密度显微毛发移植技术,综合移植多种微小型毛胚,具有手术时间短、植发密度高、覆盖效果好等优点,大部分患者Ⅰ期手术后即可获得满意的治疗效果.     

高密度自体毛发移植治疗脂溢性秃发的疗效观察

目的 探讨应用高密度显微外科毛发移植技术,综合移植多种微小型毛胚,治疗脂溢性秃发的临床效果.方法 切取患者头发生长浓密的枕、颞部头皮作为毛发移植供体,5倍专用手术显微镜下分离毛囊,制成多种微小移植毛胚,以三棱针、微型刀片和卵圆形打孔器在受区打孔,用显微外科移植镊,由前向后顺序将移植毛胚植入受区孔隙,术后定期随访.结果 32例脂溢性秃发,移植毛发的平均成活率为90%,Ⅰ期手术后患者满意度为81%,6例不满意患者行Ⅱ期手术后均达到了满意的治疗效果.随访12～24个月,毛发生长自然、密集,发质良好无脱落.结论 应用高密度显微毛发移植技术,综合移植多种微小型毛胚,具有手术时间短、植发密度高、覆盖效果好等优点,大部分患者Ⅰ期手术后即可获得满意的治疗效果.     

毛发诱导结合自体毛囊单位移植技术进行毛发定向重建的研究

目的 将异位诱导形成的毛发组织进行移植,实现毛发的定向重建.方法 制备新生C57鼠的皮肤细胞悬液注射于裸鼠体内,诱导形成皮下异位毛发组织,取出后在体视显微镜下分离成单个毛囊单位,移植至裸鼠体表,并进行大体观察和组织学检测.结果 按照预定密度移植后的毛发成活良好并呈周期性生长,组织学可见各时期相应的毛囊形态.结论 诱导形成的毛发组织可以作为移植物,通过毛囊单位移植的方式,实现毛发组织密度和方向的可控性重建.     

Method of tying up hair during hair transplantation

We have reported on a simple and secure method of tying up hair during transplantation surgery for alopecia. The implements used were Kocher's forceps and rubber bands which are readily obtainable in the operating theater.     

自体单株毛发移植修复女先天性无阴毛或阴毛发育不良

目的探索应用自体毛发单株移植修复女先天性无阴毛或阴毛发育不良的效果。方法对12例成年女性患者,均采用切取枕后区包含全厚皮肤与完整毛囊的条形头皮组织,在手术放大镜下,将头皮条全部分割成1个个单株毛发备用。用规格为0．9mm×38．0mm的针头穿刺打孔,将单株毛发移植到外阴部以增补稀疏的阴毛和扩大分布面积,每例移植400700个单株毛发,阴毛分布形态多选用倒三角形或菱形,密度为阴阜部阴毛按20株／cm^2植入,然后向外扩散密度逐步减小,最少不低于10株／cm^2。结果随访9个月至2年,植人毛发生长良好,阴毛形态及方向和分布范围均与正常接近一致,效果满意。均1次手术成功无需进行2次加密治疗,枕后供区切口瘢痕不明显。结论用毛发移植术补足阴毛,方法简便,创伤小,外形自然美观,是目前补充阴毛不足或无阴毛的理想方法。     

毛囊显微移植技术治疗秃顶──附565例临床分析

目的　观察毛囊显微移植治疗秃顶的临床效果。方法　通过毛囊显微移植技术治疗各种秃顶脱发 5 6 5例 ,随访时间平均 1年 (8～ 14个月 )。结果　术后平均 2～ 3个月长出头发 ,5～ 6个月达到初步视觉效果。 5 6 5例手术中 ,男女性正常脱发及眉毛移植的毛囊存活率为 95 %～ 10 0 % ,瘢痕毛囊移植存活率达 90 %以上 ,头发生长速度、发质粗细度均保持了供发区毛发的特性。结论　该手术时间短 ,恢复快 ,经过 3年临床观察 ,该技术在中国人群中能达到良好的效果。     

毛发移植修复外伤后眉缺损的临床观察

目的 观察因外伤、烧伤等致眉毛缺损的患者,采用自体单株毛囊种植修复的临床效果.方法 对73例因外伤或烧伤造成眉弓区瘢痕,或经游离皮肤移植及皮瓣、扩张皮瓣修复后致眉毛缺损的患者,根据所需移植物大小,相应地选用21 G或22 G注射器针头穿刺打孔,在针头退出的同时,用显微镊植入制备好的单株毛囊,修复其形态.结果 本组共73例患者,其中4例术后出现毛囊炎,经用75％乙醇涂擦后痊愈.其余患者的植入毛发生长良好,方向及形态满意,成活率在90％以上.结论 对于外伤、烧伤后致眉缺损的患者,采用自体单株毛囊种植修复技术,虽然在操作上有一定难度,但仍以毛发移植修复为宜;对于眉弓区软组织条件不适合进行眉毛种植的患者,可以针对其原因进行治疗,然后采用毛发移植修复缺损,也能获得良好的效果.     

Ruby laser-assisted hair removal – correlation of efficacy with the growth cycle of human hair

There is great variation in response when ruby laser is used to remove unwanted body hair. Destruction of hair is often not possible after one laser treatment and the frequency and timing of repeated treatments required to achieve optimum treatment results are unknown. It was the aim of this study to determine whether the efficacy of ruby laser hair removal depended on the hair growth cycle. A prospective clinical study was carried out. The lower legs of 48 patients were treated with the Chromos 694 ruby laser at a standard fluence of 11 Jcm^–2. Treatment efficacy was determined as the percentage decrease in hair density at 3 and 7 months. The proportion of growing and resting hairs in the treatment site was assessed by examination of plucked hair roots harvested from areas adjacent to the treatment site. To determine whether examination of plucked hair roots microscopically was reliable in assessing the proportion of growing and resting hairs in a specific site, 7 ex-vivo scalp skins were examined histologically. Results showed that examination of plucked hair roots was a reliable method in assessing the proportion of growing and resting hair. There was no correlation between the treatment efficacy and the growth phases of hair (one way analysis of variance, P=0.116). In conclusion, growing hairs are not more susceptible than resting hairs to ruby laser injury. The clinical implications of this finding are discussed. Received: 14 November 1998 / Accepted: 4 December 1999     

自体单株毛囊种植修复上唇胡须缺损

目的:探索应用自体单株毛囊移植修复上唇胡须缺损的效果。方法:对17例患者采用切取枕后安全区头皮条的方法或利用直径8mm的电动环钻获取毛发移植物,在3倍放大镜下制成单株移植物,并利用21或22G注射器针头穿刺打孔,然后用显微镊夹持毛干部,将毛发移植到缺损处以修复形态。结果:植入毛发生长良好,形态满意,移植毛发成活率在95%以上。结论:单株自体毛囊种植修复胡须缺损是一个适宜的方法。     

超级脱毛模式的临床效果观察

目的 探讨超级脱毛模式（super hair remoral,SHR）的临床效果及耐受程度.方法 采用SHR对发际、面颊、上唇、胡须、胸腹、乳晕周围、腋窝、四肢及比基尼邻近区等共进行了1 000个部位的脱毛;对一些疼痛特别敏感的部位,如上唇及头面部,治疗时采用复方利多卡因乳膏外涂1 h以上.结果 四肢、胸腹、背部及腋窝部位的毛发,一般需要4～5次治疗方可达到根治目的 ,且美容就医者无明显不适感;上唇、下颌周围毛发一般需要5～7次治疗方可收到满意效果,且需要外涂麻药,否则部分美容就医者会呈现不适感.结论 SHR模式与传统脱毛方式、光子脱毛及其他激光脱毛方式相比,具有有效性高、脱毛速度快、耐受性强等优点,值得推广.     

Meta-analysis of hair removal laser trials

Traditional hair-removal techniques have included shaving, waxing, chemical depilation, and electrolysis. All of these methods result in temporary hair removal. The theory of selective photo thermolysis led to the development of a variety of different laser systems. These lasers range from the short end of spectrum, with the 694-nm ruby laser, to the middle, with the 755-nm alexandrite and 810-nm diode lasers, and to the long end with the 1,064-nm Nd:YAG laser. We made a systematic review on the clinical trials with use of various laser sources for hair removal, so all clinical trials related to hair removal lasers in 1998–2003 were considered after elimination of heterogenite sources in data store. Trial results were synthetized on the basis of kind of laser. Our study clarified that hair reduction at least 6 months after the last treatment and hair reductions were 57.5, 42.3, 54.7, and 52.8% after three sessions for diode, Nd:YAG, alexandrite and ruby, respectively. We compared the result with use of analysis of variance method (Scheffes) and double comparison with use of Student’s t test. Our results clarified that diode laser is the most effective, and Nd:YAG has the least effect of hair removal.It seems that diode and alexandrite lasers are proper for hair removal, but as we need high fluence in the darker skin types and this is accompanied with higher complications, diode is advised for lighter skin, and we advised alexandrite laser for darker skin types.     

The tumescent technique facilitates hair micrografting

Micrografting for hair restoration has become increasingly popular because of the natural results it can achieve. The procedure is often performed under local anesthesia or local anesthesia with sedation. To achieve adequate anesthesia, supraorbital and supratrochlear nerve blocks are often performed as well as infiltration of the donor and recipient areas via multiple needle injections. These nerve blocks and multiple injections are associated with significant discomfort and may need to be repeated if anesthesia is inadequate. In addition, because of the rich vascularity of the scalp, donor site and recipient bed bleeding are often encountered, making the procedure more difficult and increasing postoperative bruising and morbidity. In an attempt to alleviate these difficulties and increase patient comfort, the tumescent technique was employed in 50 consecutive micrografting procedures. The ability to achieve anesthesia in the donor and recipient beds without the need for additional nerve blocks was evaluated. The ability of the tumescent technique to minimize bleeding and subsequent postoperative ecchymosis and morbidity was analyzed. The findings of this study suggest the tumescent technique is useful in facilitating hair micrografting. It consistently achieves excellent anesthesia in both donor and recipient sites without the need for multiple needle injections or nerve blocks. The duration of anesthesia is significant, allowing completion of the procedure and offering prolonged postoperative anesthesia as well. Bleeding can be minimized using the tumescent technique for both donor site harvesting and the micrografting procedure itself.