自体脂肪颗粒移植填充眶隔矫正重度上睑凹陷  

Filling orbital septum with autologous fat transplantation to correct severe upper eyelid depression

作　　者：陈长永[1] 李文志[1] 李斌斌[1] Chen Changyong;Li Wenzhi;Li Binbin(Department of Plastic Surgery and Laser Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院整形美容和激光医学科,北京100029

出　　处：《中华整形外科杂志》2023年第5期540-545,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨采用自体脂肪颗粒移植填充眶隔治疗重度上睑凹陷的临床效果。方法回顾性分析2019年1月至2021年1月首都医科大学附属北京安贞医院收治的重度上睑凹陷患者的临床资料。从腹部或大腿内侧获取颗粒脂肪,选取上睑凹陷的中部、靠近眉部隐蔽部位作为进针点,填充针依次穿过皮肤、皮下脂肪层、眼轮匝肌、眼轮匝肌后脂肪垫、眶上缘,紧贴眶上壁进入眶隔,将脂肪颗粒注射至眶隔内,直至上睑凹陷获得矫正,且略为饱满。术后对患者上睑凹陷改善情况和并发症发生情况进行随访,对于上睑凹陷矫正欠佳者间隔半年后再次行自体脂肪颗粒注射。结果共纳入42例重度上睑凹陷患者,均为女性,年龄18~57岁,平均36.8岁。术中每侧上睑眶隔内脂肪注射量为1.8~3.0 ml。术后随访6~12个月,经1次脂肪填充后有39例患者(92.9%)上睑凹陷明显改善,另3例患者(7.1%)经过2次脂肪填充,凹陷得到有效改善;术后2~3 d有4例上睑出现脂肪结节,经医生局部反复按摩后消退;所有病例均未发生血肿、上睑下垂、栓塞等并发症。结论通过在眶隔内填充自体脂肪颗粒可以有效改善重度上睑凹陷,恢复眼睑年轻化外观。Objective To investigate the clinical effect of filling orbital septum with autologous fat granules for correction of severe upper eyelid depression.Methods From January 2019 to January 2021,the data of patients with severe upper eyelid depression admitted to Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed.Fat granules were obtained from the abdomen or inner thigh.The middle part of the upper eyelid depression near the lower edge of eyebrow were selected as the injection point.The needle for filling was successively passed through the skin,subcutaneous fat layer,orbicularis oculi muscle,retro-orbicularis oculi fat,and the superior orbital margin.The needle was inserted into the orbital septum closedly to the superior orbital wall.Fat granules were injected into the orbital septum until the upper eyelid depression was corrected with slight fullness.Postoperative follow-up was conducted on the improvement of upper eyelid depression and the occurrence of complications in the patients.For the patients with poor correction of upper eyelid depression,autologous fat granule injection was performed again half a year later.Results A total of 42 female patients with severe upper eyelid depression were included,aged 18-57 years with an average age of 36.8 years.Fat injection volume was 1.8-3.0 ml in each side.After 6-12 months of follow-up,39 patients(92.9%)were significantly improved after one operation,and the other 3 patients(7.1%)were effectively improved after two fat filling.2-3 days after operation,4 cases of fat nodules appeared on upper eyelid,which subsided after local repeated massage by doctors.No complications such as hematoma,ptosis and embolism occurred.Conclusion Filling the orbital septum with autologous fat granules can effectively improve the severe upper eyelid depression to attain eyelid rejuvenation.

关 键 词：眼睑 眶隔 上睑凹陷 自体移植物 脂肪颗粒移植术 

分 类 号：R779.6[医药卫生—眼科]