改良注射法改善颞部凹陷畸形的临床治疗效果及安全性分析  

Clinical effect and safety of modified injection approach in temporal area depression

作　　者：张明子 李之瑾 夏文波 邱子锴 马旭达 陈思超 斯楼斌 刘志飞 王晓军 Zhang Mingzi;Li Zhijin;Xia Wenbo;Qiu Zikai;Ma Xuda;Chen Sichao;Si Loubin;Liu Zhifei;Wang Xiaojun(Department of Plastic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Orthopedics,Qingdao Huangdao District Hospital of Traditional Chinese Medicine,Qingdao 266500,China)

机构地区：[1]中国医学科学院、北京协和医院整形美容外科,北京100730 [2]青岛市黄岛区中医医院骨伤科,青岛266500

出　　处：《中华医学美学美容杂志》2025年第2期138-142,共5页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-041)。

摘　　要：目的探讨改良注射法改善颞部凹陷畸形的临床治疗效果及安全性。方法前瞻性纳入2019年6月至2022年6月中国医学科学院北京协和医院整形美容外科行颞部凹陷填充的女性患者157例,年龄32~48(38.2±3.1)岁。通过吸脂纯化获得颗粒脂肪,以额颞线中点入路,于皮下、颞浅筋膜下多点、均匀注射颗粒脂肪组织,同时于颞部边缘区域补充适当颗粒脂肪,兼顾流畅性。利用视觉模拟评分(VAS)对患者术中的疼痛程度进行评估。术后随访1年,对患者术前、术后照片的颞部凹陷改善程度、局部色斑改善程度以及眶外侧区细纹改善程度进行满意度评估。同时记录患者术后即刻以及随访1年后并发症发生情况,包括肿胀、瘀斑、血肿、脂肪栓塞、感染、脂肪液化、皮下硬结等。结果157例患者术后均有轻度注射区肿胀,3~6 d消退。15例患者术后出现瘀斑,10 d自行消退。11例患者出现填充区域左右不对称,其中有3例患者经过局部按摩和观察后恢复,余8例患者进行了2次脂肪填充。进行2次以上脂肪填充的患者有25例,其中4例进行了3次脂肪填充,3例患者术后出现局部轻度血肿。术中疼痛VAS评分为(1.8±0.5)分。治疗后颞部凹陷改善程度为(7.4±0.7)分,局部色斑改善程度为(6.8±0.7)分,眶外侧区细纹改善程度为(7.9±0.7)分。157例患者经随访1年,无脂肪栓塞、感染、脂肪液化、皮下硬结等并发症。结论改良注射法改善颞部凹陷畸形安全有效,患者满意度高。Objective To investigate the clinical efficacy and safety of a modified injection technique for improving temporal concavity deformities.Methods A prospective study was conducted on 157 female patients who underwent temporal concavity augmentation at the Department of Plastic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,from June 2019 to June 2022.The patients were aged from 32 to 48(38.2±3.1)years.Granular fat was obtained through liposuction and purification.Using the midpoint of the frontotemporal line as the entry point,the granular fat tissue was injected evenly at multiple points under the skin and superficial temporal fascia.Additional granular fat was injected in the temporal edge area to ensure a smooth appearance.The visual analogue scale(VAS)was used to assess the patients'intraoperative pain levels.Follow-up visits were conducted for one year postoperatively to assess patient satisfaction with the improvement in temporal concavity,local pigmentation,and fine lines in the lateral orbital area based on preoperative and postoperative photographs.Complications,including swelling,ecchymosis,hematoma,fat embolism,infection,fat liquefaction,and subcutaneous induration,were recorded immediately after surgery and at the one-year follow-up.Results All the 157 patients experienced mild swelling in the injection area postoperatively,which resolved within 3 to 6 days.Ecchymosis occurred in 15 patients and spontaneously resolved within 10 days.Eleven patients had asymmetry in the filled area,with 3 recovering after local massage and observation,and the remaining 8 undergoing a second fat grafting procedure.A total of 25 patients underwent more than two fat grafting procedures,including 4 who underwent three procedures.Mild local hematoma occurred in 3 patients postoperatively.The intraoperative pain VAS was(1.8±0.5)score.After treatment,the improvement scores for temporal concavity,local pigmentation,and fine lines in the lateral orbital area were(7.4±0.7),(6.8±0.7),and(7.9�

关 键 词：注射 改良注射 颞部填充 脂肪移植 临床应用 效果评价 

分 类 号：R622[医药卫生—整形外科]