色素痣分次切除的手术适应证研究

目的探讨分次切除治疗较大色素痣的手术适应证。方法对46例不同部位先天性色素痣(面部22例,躯干部13例,四肢11例)采用部分切除治疗,比较术前、术后近期、术后远期病变大小及局部情况的差异。结果术后近期病变面积较术前明显缩小(P0.05),术后远期较近期病变面积有不同程度增大(P0.05),但与术前相比仍存在统计学差异(P0.05)。1例面部色素痣患者存在轻度变形,2例四肢色素痣患者存在轻度活动受限。结论先天性色素痣应首选一次性切除病变,但不同部位色素痣具有不同的手术适应证。面部及四肢跨关节的色素痣更适宜采用分次切除进行治疗,而躯干部及四肢非关节部位应力求一次性切除病变。

Investigation on Surgical Indications of Fractional Resection to Pigmented Nevus

Objective To investigate the surgical indications of fractional resection to pigmented nevus. Methods 46 cases of congenital pigmented nevus in different parts were treated by partial resection, including 22 of face, 13 of trunk and 11 of extremities. Differences of lesion size and local circumstance in pre-operation, postoperative short-term and postoperative long-term were compared. Results The area of pigmented nevus in postoperative short-term was significantly reduced than that of pre-operation （P 〈 0.05）. The lesion size in postoperative long-term was enlarged with different degrees than that in post-operative short-term, whereas was obviously decreased than that in pre-operation, there was remarkable statistic difference （P 〈 0.05）. Slight deformation was found in 1 case with facial pigmented nevus, and slight activity limitation was in 2 cases with pigmented nevus in extremities. Conclusions Complete resection should be the first choice for congenital pigmented nevus. Different indications of surgical intervention are suitable for pigmented nevus in different parts. Fractional resection is more suitable for pigmented nevus in face or limbs across joints, while complete resection is more suitable for pigmented nevus in trunk or non-articular limbs.