自体颗粒脂肪移植治疗增生性瘢痕的临床研究  

Clinical Study on Autologous Granular Fat Transplantation in the Treatment of Hypertrophic Scar

作　　者：何林 都慧聪 周林[1] 张卓 余学元 舒茂国[1] HE Lin;DU Huicong;ZHOU Lin;ZHANG Zhuo;YU Xueyuan;SHU Maoguo(Department of Plastic,Aesthetic and Maxillofacial Surgery,the First Affi liated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院整形美容颌面外科,陕西西安710061

出　　处：《中国美容医学》2022年第4期39-42,共4页Chinese Journal of Aesthetic Medicine

基　　金：陕西省重点研发计划(编号:2019SF-106)。

摘　　要：目的:探讨自体颗粒脂肪移植治疗增生性瘢痕的临床效果。方法:选取15例1年以上增生性瘢痕患者,给予瘢痕内注射自体颗粒脂肪治疗(0.5 ml/cm^(2)),于治疗前及治疗6个月后,采用患者观察者瘢痕评估量表对瘢痕进行评估,其中4例患者自愿取材进行病理检测。结果:15例患者均获得了随访,无感染、血肿、脂肪栓塞等并发症发生。治疗6个月后,患者瘢痕疼痛、瘙痒症状无明显改善,瘢痕厚度、粗糙程度、规则程度等改善不明显,差异无统计学意义(P>0.05);瘢痕颜色、硬度、血管分布等得到了显著改善,差异有统计学意义(P<0.05)。患者及观察者评估总分均较治疗前得到改善,差异有统计学意义(P<0.05)。Masson染色结果显示瘢痕胶原纤维蓝染变浅,变得稀疏,排列较治疗前有序。结论:自体颗粒脂肪移植可改善增生性瘢痕的颜色、质地和柔软度,但对患者的疼痛、瘙痒症状及瘢痕厚度、规则程度等改善不明显,总体治疗效果有限,有待进一步研究。Objective To investigate the clinical effect of autologous granular fat transplantation in the treatment of hypertrophic scar. Methods 15 patients with hypertrophic scar for more than one year were treated with intrascar injection of autologous granular fat(0.5 ml/cm^(2)). Before and 6 months after treatment, the scar was evaluated by the Patient and observer scar assessment scale(POSAS), of which 4 patients voluntarily took materials for pathological examination. Results All 15 patients were followed up and there were no complications such as infection, hematoma and fat embolism. After 6 months of treatment,the symptoms of scar pain and pruritus were not significantly improved, and the thickness, roughness and regularity of scar were not significantly improved, the differences were not statistically significant(P>0.05). The color, hardness and vascular distribution of scar were significantly improved, the differences were statistically significant(P<0.05). The total evaluation scores of patients and observers were improved compared with those before treatment(P<0.05). Masson staining showed that the blue staining of scar collagen fibers became lighter and sparse, and the arrangement was more orderly than that before treatment. Conclusion Autologous granular fat grafting has a good therapeutic effect in color, vascularization and pliability of hypertrophic scar. But the therapeutic effect in pain, itch, thickness and relief of the scar was not obviously. The general therapeutic effect of fat grafting in hypertrophic scar is limited and need more investigation.

关 键 词：自体颗粒脂肪移植 增生性瘢痕 病理检测 胶原纤维 

分 类 号：R619.6[医药卫生—外科学]