彩色多普勒超声辅助下行面部注射填充的效果  

Efficacy of Doppler ultrasound-assisted facial filler injection

作　　者：李芯 徐雯 杨晓宁 于璐 林贞姬[3] 马继光 Li Xin;Xu Wen;Yang Xiaoning;Yu Lu;Lin Zhenji;Ma Jiguang(Department of Facial Cosmetic Center,Plastic Surgery Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100144,China;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Burn and Plastic Surgery,Jilin Central Hospital,Jilin 132011,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院面颈整形美容二中心,北京100144 [2]中国医学科学院北京协和医学院北京协和医院超声医学科,北京100730 [3]吉林省吉林市中心医院烧伤整形科,吉林省吉林市132011

出　　处：《中华医学美学美容杂志》2021年第5期379-382,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：国家重点研发计划(2017YFC1103604)。

摘　　要：目的根据面部血管的解剖,探讨在彩色多普勒超声(彩超)辅助下进行面部注射填充治疗的效果及安全性。方法2019年1月至2020年9月,中国医学科学院整形外科医院面颈整形美容二中心收治要求面部填充患者142例,男11例,女131例,年龄17~68岁,平均39.7岁。根据患者意愿分别用自体脂肪或透明质酸进行面部注射填充,多普勒彩超辅助下,助手以手指对眶部特定血管进行加压按压,使动脉暂时性压闭,以钝针边退边注射,待注射完成时再松开手指。结果自体脂肪组填充治疗54例,透明质酸组填充治疗88例,填充部位包括额部、颞部、眉间、鼻部、泪沟、鼻唇沟、颧颊部、颏部及唇部等,注射部位形态改善满意,达到面部年轻化的改善效果,无1例发生血管栓塞,其中9例接受2~3次脂肪填充。术后随访1~6个月,早期肿胀、瘀斑,在7 d左右明显好转。面部脂肪填充患者术后早期存在局部肿块情况,1个月左右缓解无明显硬结形成。结论彩超辅助下以手指用力按压眶部特定血管,方法简单易行,对患者无附加伤害,值得临床应用。Objective To explore the safety and efficacy of ultrasound-assisted facial filler injection,based on the anatomy of facial vessels to prevent intravascular embolization.Methods From Jan.2019 to Sep.2020,142 patients were treated with facial soft-tissue filler injection(mean age,39.7 years;131 female and 11 male).According to the patients'own will,autologous fat or hyaluronic acid was applied respectively.When injecting,the assistant could press over the periorbital artery to temporarily occlude the artery,confirmed with Doppler ultrasound,thus reduced the risk of intravascular embolization,and carefully injected with minimal pressure and tiny amount.Results A total of 142 patients were enrolled in the study,and 54 patients were treated with autologous fat grafting,while 88 patients were injected with hyaluronic acid.The injection sites included forehead,temple,glabella,nasal root,tear trough,nasolabial fold,cheek,chin,and lips.Facial rejuvenation improvement was satisfied with a smooth contour and proper augmentation.No vascular embolization occurred.9 patients received a second or third round fat grafting to achieve better outcome.Follow-up duration ranged from 1 month to 6 months.Conclusions With ultrasound assistant,digital pressure over the orbital artery could temporarily occlude the artery and may reduce the risk of intravascular embolization.The simple technique may add a significant benefit with no additional cost or risk to the patients.

关 键 词：面部 注射 血管栓塞 注射美容 预防策略 

分 类 号：R622[医药卫生—整形外科]