半面萎缩的自体脂肪颗粒移植治疗  

TREATMENT OF AUTOLOGOUS FAT INJECTION FOR HEMIFACIAL ATROPHY

作　　者：谢芸[1] 李青峰[1] 郑丹宁[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海200011

出　　处：《中国修复重建外科杂志》2007年第12期1308-1311,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：上海市科技发展基金资助项目(034119826)~~

摘　　要：目的对半面萎缩的治疗采用改良自体脂肪颗粒移植技术,提高脂肪成活率,减少术后脂肪液化、坏死、吸收等并发症。方法1999年3月～2004年10月,治疗31例稳定期半面萎缩患者。男12例,女19例;年龄19～28岁,平均23.5岁。根据半面萎缩范围不同分成3型,轻度萎缩9例,中度萎缩19例,重度萎缩3例。根据以往研究结果和文献的总结分析,在脂肪的获取和移植上,采用低位供区、低压抽取、低速离心和多点、多隧道、多层面放射状注射移植。经术前、术后正位、侧位45°及90°照片比较,以及术后表情是否自然,局部有无硬块和囊肿,患者感觉舒适度等评价标准,并根据随访结果决定是否需再次手术。结果术后31例均达到面部外形基本对称。1次注射15例,2次13例,3次3例。第3次注射后较第2次效果好,第2次注射比第1次效果好,且注射量逐次减少。下颌部注射量8～14ml,平均11ml;颊部注射量15～25ml,平均20ml;颧部注射量5～10ml,平均7.5ml;额部注射量18～20ml,平均19ml。患者随访3～5年,未发现感染、硬结、皮下包块、囊肿或其他并发症。患侧皮肤色素增生明显减轻。结论与传统治疗方法比较,自体脂肪颗粒注射移植治疗能达满意面部对称,且无供区损伤及受区并发症,是治疗半面萎缩一种较理想的手术方法。Objective To evaluate an improved treatment of an autologous fat injection for hemifacial atrophy to increase the survival rate of the fat graft and decrease complications including colliquation, necrosis, and absorption of the graft fat. Methods From March 1999 to October 2004, 31 patients with hemifacial atrophy underwent an improved treatment by an autologous fat injection for their diseases. There were 12 males and 19 females aged 19-28 years （average, 23.5 years）. The patients were divided into the following 3 groups according to the atrophy extent the mild group （n=9）, the moderate group （n=19）, and the severe group （n=3）. Based on the previous researches on the fat transplantation techniques, the improved treatment combined the following strategies that were simply called ＂3L3M＂.. low position for the fat donation, low pressure for the fat harvesting, and low-speed centrifugation for purification of the fat ; multi-point, multi-tunnel, and multi-plane for injections of the fat graft. The preoperative and the postoperative photos were taken and the findings were compared to make clear whether the hard and firm masses and cysts existed ; then, the decision was made about whether the patients needed another operation according to whether the patients had a natural facial expression and whether the patients had comfortable feelings as well as the X-ray findings. Results All the patients had a satisfactory symmetrical face after 1 injection of the fat in 15 patients, 2 injections in 13 patients, and 3 injections in 3 patients. The effect of the 3rd injection was better than that of the 2nd injection; the effect of the 2nd injection was better than that of the 1st injection; the fat volume for the injection could be gradually decreased. The fat volumes for injections were as follows.. 8-14 ml （average, 11 ml） in the submaxillary region, 15-25 ml （average, 20 ml） in the buccal region, 5-10 ml （average, 7.5 ml） in the zygomatic region, and 18- 20 ml （average, 19 ml） in the foreh

关 键 词：半面萎缩 自体脂肪移植 脂肪注射 

分 类 号：R622[医药卫生—整形外科] R782.26[医药卫生—外科学]