[1]杨文,周启星,成琦,等.儿童先天性巨痣的病理特征及手术疗效探讨[J].临床小儿外科杂志,2018,17(02):131-135.
　Yang Wen,Zhou Qixing,Cheng Qi,et al.The discussion over pathological features and the effect of surgical treatment of children with giant pigmented nevus.[J].Journal of Clinical Pediatric Surgery,2018,17(02):131-135.
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儿童先天性巨痣的病理特征及手术疗效探讨

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第17卷 期数: 2018年02期 页码: 131-135 栏目: 论著 出版日期: 2018-02-28
Title:
The discussion over pathological features and the effect of surgical treatment of children with giant pigmented nevus.
作者:
杨文; 周启星; 成琦; 等.
华中科技大学同济医学院附属武汉儿童医院
Author(s):
Yang Wen1; Zhou Qixing1; Cheng Qi1; Han Kun1; Zhang Yong1 ; Chen Jun1; Wu Dingan1; Fan Lifang2.
1.Department of PlasticSurgery,Wuhan Childrens Hospital（Wuhan Maternal and Child Healthcare Hospital）, Tongji Medical College, Huazhong University of Science & Technology,Wuhan,Hubei 430016,China;
关键词:
痣／先天性; 外科手术; 治疗; 病理; 儿童
Keywords:
Nevus/CN;  Surgical Procedures; Operative;  Therapy;  Pathology;  Child
文献标志码:
A
摘要:
目的　探讨儿童先天性巨痣的治疗方法、手术时机及其与病理之间的关系。　方法　回
顾性分析近年来本院收治的２８例先天性巨痣患儿临床资料，其中男１８例，女１０例；头面部１３例，肢体
及躯干部１５例，术后标本进行ＨＥ染色。１例头部发际线以内巨痣采用埋置扩张器，二期手术切除；２３
例采用一次性全部切除植皮；１例采用分次切除病变组织，植皮覆盖创面的方法；其余３例因痣体大，患
儿年龄大肢体长，供皮不够，且位于跨关节处，采取部分切除植皮。　结果　所切除的巨痣血液供应均
较正常皮肤丰富，累及浅筋膜者皮下脂肪均较稀少。ＨＥ染色病理检查２例为黑色素细胞交界痣
（７％），２６例为复合痣（９３％），均未发生恶变。２８例术后伤口均Ⅰ期愈合，愈合均满意。　结论　先天
性巨痣具有良性肿瘤的细胞生物学特性，尽早进行整形外科手术可减轻手术瘢痕，较好恢复患儿外形
及功能，去除面积及所需去除组织少，且病理上可减少恶变几率，较大程度上减轻患者的心理伤害。
Abstract:
ObjectiveTo explore the association among surgical techniques,surgical timing and pathological features of children Giant Pigmented Nevus.Methods28 cases with Giant Pigmented Nevus on children who were treated in our deparment from June 2009 to December 2014,were retrospectively analyzed.These cases include 18 males and 10 females,in which 13 cases on the head and face region and 15 cases on the body and limb region.The samples are stained by using HE staining.One case of infants with giant pigmented nevi inside the hairline was cured by twostage operation with the skin expander;23 patients received fullthickness skin graft to fix the defect after excision of giant nevus;one case undertook resection surgery in different stages,with graft covering the wound;Three cases of older children undertook partial resection due to the large area of nevi,which was crossing the joints and lacking of enough skin for grafting.ResultsResected giant nevus had better blood supply than the normal skin.Subcutaneous lipid was rare due to the association with the superficial fascia.HE staining pathological examination showed that 2 cases were melanocytes borderline nevus (7%),26 cases were compound nevus (93%),and no malignant change was occurred.In 28 cases,all the wounds were healed in I stage,and the healing was satisfactory.ConclusionCongenital giant nevus has the cellular biological characteristics of benign tumors,and early plastic surgery can effectively reduce the surgical scar.Surgery can better restore the shape and function of children,remove the area and need less tissue,and reduce the risk of malignant transformation in pathology,to a large extent,reduce the psychological harm of patients.

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