脂肪来源SVF联合PRP注射改善鼻唇沟的临床研究

Improvement of nasolabial fold by combined injection of platelet rich plasma and adipose-derived stromal vascular fraction

目的 观察并分析富含血小板血浆（PRP）联合血管基质片段（SVF）治疗面部鼻唇沟的有效性及安全性.方法 对30例鼻唇沟明显的患者,从外周静脉获取血液,通过离心法获得PRP;在患者大腿外侧抽取脂肪,并通过酶解法获取脂肪组织的SVF.按一定比例混合后,注射在鼻唇沟的真皮深层及皮下组织层.治疗医师依据皱纹评估分级（WAS）,对鼻唇沟进行评估,评估时间点为术前,术后即刻、7d、1个月、3个月、6个月.结果 所有患者的鼻唇沟都得到了较大程度的改善,注射过程中及术后未出现动静脉栓塞、注射区皮肤及组织坏死、感染、纤维化、组织变硬及形成肿块等并发症.术前WAS评分为3.30±0.47,术后即刻、7d、1个月、3个月、6个月分别为1.22±0.54、0.69 ±0.45、0.98±0.55、1.18±0.64、1.23±0.72.其中,术后7d的WAS评分下降程度最低,术后观察点WAS评分与术前相比,差异均具有统计学意义（P＜0.001）.结论 PRP联合SVF疗法,在不采用外源性填充材料的情况下,可以显著改善中老年患者的鼻唇沟凹陷,有非常好的应用前景.

Objective To observe the safety and efficacy of platelet rich plasma （PRP） and stromal vascular fraction （SVF） combined injection in correcting nasolabial folds. Methods Thirty female subjects with significant nasolabial folds were enrolled. Peripheral venous blood was obtained from each subject and was centrifuged to produce platelet rich plasma （PRP）. Autologous fat was harvested from the lateral thighs of each subject to prepare the stromal vascular fraction （SVF） using enzymatic digestion. PRP and SVF were mixed proportionally, and the mixture was injected into the deep dermis and subcutaneous tissue of the nasolabial fold. The severities of nasolabial folds were evaluated by the treating surgeon using the wrinkles assessment scale （WAS） before the treatment, immediately after the treatment, at 7 days, 1 month, 3 months, and 6 months after the treatment. Results All subjects had significant nasolabial folds improvements. There were few complications, including vascular thrombosis, injection site skin or tissue necrosis, infection, fibrosis, tissue hardening or lumps, observed during and after the injection. Mean WAS scores immediately the treatment, at 1 week, 1 month, 3 months, and 6 months after treatment were 1.22 ± 0.54, 0.69 ±0.45, 0.98 ± 0.55, 1.18 ± 0.64, 1.23±0.72 respectively, which were significantly lower than the score before the treatment （ P〈0. 001 ）. Conclusion The combined injection of PRP and SVF, without using any exogenous filler, can significantly improve the nasolabial depression of middle to elderly age patients. This technique may have good clinical applications in the future.