颗粒脂肪与脱细胞真皮基质微粒联合移植的实验研究  

An experimental study on transplantation of granular fat combined micronized acellular dermal matrix

作　　者：叶明敏 曹广通[2] 刘毅 Ye Mingmin;Cao Guangtong;Liu Yi(Department of Burns and Plastic Surgery,the 940th Hospital of the Joint Logistics Support Force of PLA,Lanzhou 730050,China;Department of Burns and Plastic Surgery and Wound Repair Surgery,Second Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]解放军联勤保障部队第九四○医院烧伤整形科,兰州730050 [2]兰州大学第二医院烧伤整形与创面修复外科,兰州730030

出　　处：《中华整形外科杂志》2023年第11期1236-1243,共8页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金地区科学基金(82360444)。

摘　　要：目的探索脱细胞真皮基质微粒(mADM)与颗粒脂肪联合注射后是否能提高移植物体积保留率及二者混合的适宜比例。方法2022年11月至2023年3月,于解放军联勤保障部队第九四○医院动物实验科取16只大鼠腹股沟脂肪,剪碎后与mADM分别以不同比例混合,另取15只大鼠分别在背部两侧注射不同的填充物。根据注射物的不同,分为6组,对照组为单纯颗粒脂肪组(C1组)、单纯mADM组(C2组),实验组分别为颗粒脂肪与mADM 1∶1混合组(E1组)、颗粒脂肪与mADM 2∶1混合组(E2组)、颗粒脂肪与mADM 4∶1混合组(E3组)、颗粒脂肪与mADM 6∶1混合组(E4组),每组注射0.5 ml,分别于第4、8、12周随机抽取5只取出标本检测移植物的体积,对移植物进行组织学分析并观察新生血管生成情况。采用SPSS 25.0软件进行统计分析,对整体多组间、多时间点数据比较采用重复测量方差分析,多组间各时间点数据比较采用单因素方差分析。P<0.05为差异有统计学意义。结果6组移植物体积均随时间有显著变化,差异有统计学意义(P<0.05),在注射后的第4、8、12周,C2组体积均大于C1组,在各实验组中,E1组体积保留率最高。组织学分析显示,C2组早期无明显炎性细胞浸润,8周后逐渐发生炎症反应,C1组可见空泡形成,且炎性细胞浸润明显,实验组中E1组炎症反应最轻微;mADM与颗粒脂肪混合注射物随mADM占比越大,其胶原纤维越多、排列越规则。6组移植物新生血管数量在移植后第4周差异有统计学意义(P<0.05),在8、12周差异无统计学意义(P>0.05)。结论mADM联合颗粒脂肪皮下注射能较长时间有效维持注射物的体积,且二者1∶1混合后效果较为适宜。ObjectiveTo investigate whether the combined injection of micronized acellular dermal matrix(mADM)and granular fat can improve the volume retention rate of the graft and the optimal mixture ratio of these two elements.MethodsFrom November 2022 to March 2023,the inguinal fat of rats was collected from the Animal Experiment Department of the 940th Hospital of the Joint Logistics Support Force of PLA,and then mixed with mADM in different proportions.Subsequently,different mixtures were injected into both sides of the back in another group of 15 rats:granular fat group(control group,C1),mADM group(control group,C2),granular fat+mADM(1∶1)group(experimental group,E1),granular fat+mADM(2∶1)group(experimental group,E2),granular fat+mADM(4∶1)group(experimental group,E3),granular fat+mADM(6∶1)group(experimental group,E4),and 0.5 ml was injected in each group.At the 4th week,8th week and 12th week,5 specimens were randomly selected to detect the volume of grafts,histological analysis and neovascularization of grafts.SPSS 25.0 software was used for statistical analysis.Repeated measures analysis of variance was used to compare the data at multiple time points among multiple groups,and one-way analysis of variance was used to compare the data at each time point among multiple groups.P<0.05 was considered statistically significant.ResultsThe volume of the grafts in the 6 groups changed significantly with time,and the difference was statistically significant(P<0.05).At the 4th,8th and 12th week after injection,the volume of C2 group was larger than that of C1 group.The histological analysis showed that there was no obvious inflammatory cell infiltration in the early stage of C2 group,and the inflammatory reaction gradually occurred after 8 weeks.In the C1 group,vacuolization was observed,and the inflammatory cell infiltration was obvious.The larger the proportion of mADM and granular fat mixed injection,the more collagen fibers arranged regularly.There was a significant difference in the number of neovascularization amo

关 键 词：脂肪组织 移植 微粒化脱细胞真皮基质 软组织填充 注射美容 

分 类 号：R622[医药卫生—整形外科]