自体纳米脂肪混合颗粒脂肪移植治疗儿童轻度半侧颜面短小畸形  

Treatment of mild hemifacial microsomia in children by autologous nano-fat mixed granule fat transplantation

作　　者：刘燕[1] 邱林 周荣 朱海 傅跃先[1] 丁雄辉[1] 肖军[1] 李天武[1] 毛小波[1] 梅爱莲 LIU Yan;QIU Lin;ZHOU Rong;ZHU Hai;FU Yuexian;DING Xionghui;XIAO Jun;LI Tianwu;MAO Xiaobo;MEI Ailian(Department of Burn and Plastic,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing,400014,P.R.China)

机构地区：[1]重庆医科大学附属儿童医院烧伤整形科、国家儿童健康与疾病临床医学研究中心、儿童发育疾病研究教育部重点实验室、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处：《中国修复重建外科杂志》2023年第3期343-347,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨自体纳米脂肪混合颗粒脂肪移植治疗儿童轻度半侧颜面短小畸形(hemifacial microsomia,HFM)面部软组织发育不良的疗效。方法2016年7月—2020年12月,收治Pruzansky-KabanⅠ型HFM患儿24例。其中采用自体纳米脂肪混合颗粒脂肪(1∶1)移植12例(研究组),自体颗粒脂肪移植12例(对照组)。两组患儿性别、年龄以及患侧侧别比较,差异均无统计学意义(P>0.05)。将患儿面部分为Ⅰ区(颏点-下颌角-口角)、Ⅱ区(下颌角-耳垂-鼻翼外侧脚基点-口角)、Ⅲ区(耳垂-鼻翼外侧脚基点-内眦-耳轮脚),术前基于颌面部CT扫描+三维重建数据采用Mimics软件计算3区健、患侧软组织容积差,以此确定自体脂肪抽取量及注射量。术前1 d及术后1年测量健、患侧下颌角至口角距离(下颌角-口角)、下颌角至外眦距离(下颌角-外眦)、耳垂至鼻翼外侧缘距离(耳垂-鼻翼外侧缘)以及Ⅰ、Ⅱ、Ⅲ区软组织容积,计算上述指标健、患侧差值,作为评价指标进行统计分析。术后1年患儿家长、手术医师及手术组护士三方,根据患儿手术前后正位照片评价手术满意度。结果研究组、对照组分别注射脂肪(28.61±8.59)、(29.33±8.08)mL,差异无统计学意义(t=0.204,P=0.840)。注射后仅对照组1例皮下有少许脂肪钙化硬结。两组患儿均获随访,随访时间均为1年~1年6个月,研究组平均1年4个月,对照组平均1年3个月。术后1年,两组患儿健、患侧不对称均改善,研究组患儿家长、手术医师及手术组护士三方满意度均为100%(12/12),对照组满意度分别为100%(12/12)、83%(10/12)、92%(11/12)。术后两组下颌角-口角、下颌角-外眦、耳垂-鼻翼外侧缘以及Ⅰ、Ⅱ、Ⅲ区软组织容积的健、患侧差值均小于术前(P<0.05)。两组间术前上述指标差异均无统计学意义(P>0.05);术后研究组各指标均小于对照组,差异有统计学意义(P<0.05)。结论自体纳米脂肪混合颗粒脂肪移植及Objective To investigate the effectiveness of autologous nano-fat mixed granule fat transplantation in the treatment of facial soft tissue dysplasia in children with mild hemifacial microsomia(HFM).Methods A total of 24 children with Pruzansky-Kaban typeⅠHFM were admitted between July 2016 and December 2020.Among them,12 children were treated with autologous nano-fat mixed granule fat(1∶1)transplantation as study group and 12 with autologous granule fat transplantation as control group.There was no significant difference in gender,age,and affected side between groups(P>0.05).The child’s face was divided into regionⅠ(mental point-mandibular angle-oral angle),regionⅡ(mandibular angle-earlobe-lateral border of the nasal alar-oral angle),regionⅢ(earlobe-lateral border of the nasal alar-inner canthus-foot of ear wheel).Based on the preoperative maxillofacial CT scan+three-dimensional reconstruction data,the differences of soft tissue volume between the healthy and affected sides in the 3 regions were calculated by Mimics software to determine the amount of autologous fat extraction or grafting.The distances between mandibular angle and oral angle(mandibular angle-oral angle),between mandibular angle and outer canthus(mandibular angle-outer canthus),and between earlobe and lateral border of the nasal alar(earlobe-lateral border of the nasal alar),and the soft tissue volumes in regionsⅠ,Ⅱ,andⅢof healthy and affected sides were measured at 1 day before operation and 1 year after operation.The differences between healthy and affected sides of the above indicators were calculated as the evaluation indexes for statistical analysis.At 1 year after operation,the parents,the surgeons,and the nurses in the operation group made a self-assessment of satisfaction according to the frontal photos of the children before and after operation.Results The study group and the control group were injected with(28.61±8.59)and(29.33±8.08)mL of fat respectively,with no significant difference(t=0.204,P=0.840).After injection

关 键 词：半侧颜面短小畸形 纳米脂肪 颗粒脂肪 自体脂肪移植 儿童 

分 类 号：R782.2[医药卫生—口腔医学]