两种不同方法小腿缩容术的临床应用比较

Comparison on clinic application of two different methods for calf reduction

目的比较观察胫神经腓肠肌内侧头肌支切断和A型肉毒毒素注射两种小腿缩容术的临床效果。方法在2011年1月至2012年10月期间,选取来自西南医院整形美容外科门诊40例小腿肥大女性求美者,平均28.4岁。其中行胫神经腓肠肌内侧头肌支切断术者20例,行A型肉毒毒素注射者20例,分别于术前,术后3、6、12个月测量小腿最大周径和观察外形变化。结果行胫神经腓肠肌内侧头肌支切断术者术后6个月,小腿最大周径缩小比例10.73%,曲线变柔和,日常活动未受影响,效果持续至术后12个月。行A型肉毒毒素注射者术后3个月,小腿最大周径缩小比例4.58%,术后6个月复发,术后12个月作用消失。两种方法小腿最大周径缩小比例差异有统计学意义(P<0.05)。结论行胫神经腓肠肌内侧头肌支切断术效果优于行A型肉毒毒素注射,但容易发生并发症手术技术要求较高。

Objective Calf reduction is one of the new topic in the plastic and aesthetic domain. Now there are two methods： neurectomy of the nerve to the medial gastrocnemius muscle and botulinum toxin A injection. To observe and compare the clinic effect of two different methods for calf reduction. Methods During the period of 2011 January to 2012 October, 40 female patients with calf hypertrophy were chosen from the plastic and aesthetic outpatient in southwest hospital, and the average age was 28.4 years. Twenty patients were chosen for the neurectomy of the nerve to the medial gastrocnemius muscle. Twenty patients were chosen for botulinum toxin A injection. The maximum calf perimeter and the shape were measured and observed per-operation, 3 months,6 months and 12 months after operation. Results In the neurectomy group,the maximum calf perimeter was reduced for 10.73% in 6 months after operation and the muscle shape was smooth.The daily activities were not affected. The effect lasts for 12 months at least. In the botulinum toxin A group, the maximum calf perimeter was reduced for 4.58% in 3 months after operation. The calf hypertrpphy relapses 6 months after operation and the effect disappears in 12 months after operation. There was significant difference between the maximum calf perimeter in two methods（P〈0.05）. Conclusion The effect of the neurectomy of the nerve to the medial gastrocnemius muscle is better than that of botulinum toxin A injection,and the former is recommended. But the surgical skill is highly requested with more complications and the operation must be carried out carefully.