[摘要]目的：探索专项护理在眉再造同期治疗瘢痕性秃发术中的应用效果。方法：根据手术过程分两期进行专项临床护理。扩张器一期置入术后进行扩张器相关专项护理，严密监测扩张注水情况，密切观察扩张部位，防止扩张皮瓣坏死或感染;眉再造和瘢痕性秃发修复二期术后密切观察再造眉毛头皮条的颜色，避免静脉回流不畅发生。结果：本组12例患者进行了眉再造的全方位密切护理，岛状头皮瓣全部存活，头皮瘢痕全部修复，无一例皮瓣坏死。随访6～24个月，再造眉毛毛发密度与健侧非常接近，眉形自然逼真，手术效果满意。结论：在可调控眉毛密度的眉再造同期治疗瘢痕性秃发术中进行全方位护理是手术成功的重要保障。

[关键词]瘢痕性秃发;可调控眉毛;眉再造;扩张;专项护理;瘢痕

Abstract： Objective  To explore the effect of special nursing in the operation of eyebrow reconstruction and the treatment of cicatricial alopecia at the same time. Methods  According to the operation process， special nursing was carried out in two phases. After the first stage placement of expander， special nursing should be carried out for the expander， the water injection of expander should be monitored closely， and the expansion site should be observed closely to prevent the expansion flap from necrosis or infection. After two stages of eyebrow reconstruction and cicatricial alopecia repair， the color of scalp strip of reconstructed eyebrow should be closely observed to avoid the occurrence of poor venous return. Results  Twelve patients underwent this method to reconstruct the eyebrows. All the island scalp flaps survived and no flap necrosis occurred. After 6-24 months of follow-up， the hair density of the reconstructed eyebrows was very close to the healthy side， without excessive thickening and excessive sparseness. The bald hair was completely repaired， and the sutures are small and the hair can be covered. The patients were all satisfied with the surgical results. Conclusion  It is an important guarantee for the success of the operation to carry out all-round nursing during the operation of eyebrow reconstruction with adjustable eyebrow concentration and the treatment of cicatricial alopecia at the same time.

Key words： cicatricial alopecia; adjustable eyebrow; eyebrow reconstruction; expansion; special nursing; scar

瘢痕性禿发伴随眉毛缺损或眉毛缺失是头面部烧伤后较为常见的并发症[1]。应用扩张器治疗瘢痕性秃发已经是很常规的方法，效果也很显著。对于眉毛缺损的治疗，目前有一些眉毛再造的方法，其中常见的术式有游离头皮条移植或单株种植，也有带颞浅动脉为蒂的头皮瓣做眉再造。前者常因转移过程中血液供应不足使再造眉毛稀疏，后者又因血供过于良好而使再造眉毛尤为浓密不自然。武汉大学附属同仁医院整形外科采用扩张皮瓣独立调控再造眉毛的密度，使再造眉毛力求达到同健侧眉形基本无差异的效果，同时同期手术修复瘢痕性秃发的新方法。……