bFGF辅助自体脂肪颗粒注射治疗面部凹陷

AUTOLOGOUS FREE FAT PARTICLE GRAFTING COMBINED WITH bFGF TO REPAIR FACIAL DEPRESSION

目的观察bFGF辅助自体脂肪颗粒注射面部凹陷的临床效果,寻找治疗面部凹陷的有效方法。方法根据入院时间将41例面部凹陷患者随机分为两组,A组:2004年4月-2004年12月收治的12例。男5例,女7例;年龄l6～49岁。先天性额部凹陷2例,半侧面部萎缩症2例,面部创伤后瘢痕凹陷5例,面部良性肿瘤治愈后凹陷3例。病程2～19年。凹陷部位低于周围正常皮肤(0.52 ± 0.13) cm。凹陷面积(16.0 ± 5.3) cm2。B组:2005年1月-2006年5月收治的29例。男14例,女15例;年龄18～52岁。先天性额部凹陷3例,半侧面部萎缩症4例,面部创伤后瘢痕凹陷15例,面部良性肿瘤治愈后凹陷7例。病程2～20年。凹陷部位低于周围正常皮肤(0.58 ± 0.15)cm,凹陷面积(18.0 ± 6.2)cm2。A组采用单纯自体脂肪颗粒注射治疗,B组在A组基础上同时应用bFGF(4 200 IU/10 mL)辅助治疗。结果注射后A组获随访6～24个月,平均12.5个月;B组获随访6～24个月,平均13个月。A组:1次注射后6例效果满意,一次治疗满意率为50%;余6例于术后6～12个月再次注射,其中2次注射3例,3次注射3例。 B组:1 次注射后24例效果满意,1次治疗满意率为82.8%;5例患者于术后12个月再次注射。两组患者的1次治疗满意率比较,差异有统计学意义(P < 0.05)。结论面部凹陷是创伤或整形术后常见的并发症,采用bFGF辅助自体脂肪颗粒注射治疗面部凹陷安全有效。

Objective To evaluate the effect of autologous free fat particle grafting combined with bFGF to repair facial depression. Methods From April 2004 to May 2006, 41 patients with facial depression were randomized into two groups （groups A and B）. In group A, 12 cases were admitted from April 2004 to December 2004. There were 5 males and 7 females, aging 16-49 years （mean, 31 years）. The pathological causes were congenital facial depression in 2 patients, hemifacial atrophy in 2, traumatic cicatrix in 5 and benign tumor removal in 3. The course of disease was 2-19 years. The concave regions were low （0.52 ± 0.13） cm compared to surrounding normal skin, concave area （16.0 ± 5.3） cm^2. In group B, 29 cases were admitted from January 2005 to May 2006. There were 14 males and 15 females, aging 18-52 years （mean, 37 years）. The pathological causes were： congenital facial depression in 3 patients, hemifacial atrophy in 4, traumatic cicatrix in 15 and benign tumor removal in 7. The course of disease was 2-20 years. The concave regions were low （0.58 ± 0.15 ） cm compared to surrounding normal skin, concave area （18.0 ± 6.2） cm^2. Cases in group A were treated with pure autologous free fat particle injection; cases in group B were treated with autologous free fat particle injection combined with bFGF（4 200 IU/10 mL）. The clinical outcome were comparatively analyzed between two groups after operation. Results The follow-up time was 6 to 24 months （mean, 12.5 months） in group A and 6 to 24 months （mean, 13 months） in group B. In group A, 6 patients achieved satisfactory clinical effect after one injection of fat particle, the satisfactory rate of one therapy being 50%; other 6 cases were required reinjection of fat particle 6-12 months postoperatively, of which two-time injections in 3 cases, three-time injections in 3 cases. In group B, 24 patients achieved satisfactory d inical effect after one injection of fat particle, the satisfactory rate of one therapy being 82.8%; only 5 cases were required reinjection one year postoperatively. There was statistically significant difference in the satisfactory rate of one injection between two groups （P 〈 0.05）. Conclusion Autologous free fat particle grafting combined with bFGF to treat facial depression can acquire satisfactory clinical effect, which is a safe and effective method.