毛发移植术中单株毛囊单位分离技术的培训研究(1)
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[摘要]目的：探讨毛发移植术中单株毛囊分离的培训方法。提高毛发移植手术人员单株毛囊分离速度和精度。方法：首先对培训对象进行毛囊结构理论教学，要求学员掌握毛囊的基本结构；然后进入镜下分离，裸眼分离结合的培训阶段，使学员掌握正确的分离技术和分离出毛囊单位的标准；最后对头皮扩张器手术的剩余头皮中的毛发进行裸眼毛囊分离培训。分离基本过程为皮条分割、粗胚制作、细胚制作，单株分离。培训过程中考核学员的分离速度和分离出的毛囊合格率。结果：理论培训后结合显微分离，显著提高了术者分离的精度；裸眼分离可以明显提高单株毛囊制作速度；经过累计超过6h或>1000个毛囊单位的分离的培训，术者分离细毛胚的速度可以达到(8±3)根/min,合格率达92±1%。与培训前有统计学差异P<0.05，和熟练术者无统计学差异。结论：毛发移植术的制约点是毛发分离速度，经过毛囊结构理论学习和体式显微镜下分离的培训，术者对毛囊结构从理论和实际上有了明确的掌握，从而提高了术者的分离精度；经过累计6h的分离训练，多数学员可以达到(8±3)根/min的分离毛囊单位速度，这一结果极大的缓解了毛发移植的限速关键点，为提高毛囊的存活率提供了坚实的技术保障。
[关键词]毛发移植；单株移植；体式显微镜
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)03-0413-03
Research on Training Program for Follicular Unit Dissection Technique in Hair Transplantation
GUAN Hao,ZHOU Qin,HOU Hong-yi,XU Zhi-gang,HU Xiao-long,LI Xiao-qiang,LI Jun,WANG Yun-chuan,MIAO Wen,TIAN Yu-xin,WU Xu-hong,HAN Fei,YANG Hong-lin,ZHU Xiong-xiang,HU Da-hai
(The Burn Center of PLA,Xijing Hospital,The Fourth Military Medical Universit,Xi'an 710032,Shaanxi,China)
Abstract: Objective To explore the training program for follicular unit dissection technique in hair transplantation. Try to improve the dissection speed and qualified rate. Method After theory learning about the hair follicle structure, microscopic separations combined with visual separation of follicular unit were performed. Results After training experiment group dissection speed 8±3 units/min qualified rate 92±1%.There are obviously difference between after training and before training (P<0.05).On the contrary there are no difference between after training group and control group. Conclusion The key restrict point of hair transplantation is follicular unit isolate. Our training program improved the speed and qualified rate by theory and reality learning. It was documented who passed theory and > 6 hours or >1000 units isolate training can performed (8±3)units/min. This program proved a technical support in hair transplantation operation.
Key words:hair transplantation;follicular unit transplantation;stereomicroscope
最早的毛发移植手术是日本学者报道的(Sasagawa 1930；Okuda 1939)[1]，随着技术的发展，目前毛发移植最常用的有FUT(follicular unit transplantaion)技术和FUE(follicular unit extraction)两种技术，二者区别的关键就是毛囊单位的获得方式[2]。其中FUE技术需要专用的毛囊提取设备，故多数单位开展的还是FUT技术。采用该技术毛发移植手术成功的关键就是单株毛囊分离的分离单株毛囊的分离速度和质量，分离的速度和质量在很大程度上决定了毛发移植术的成败[3] ......
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