纳米脂肪联合颗粒脂肪注射治疗下睑混合型黑眼圈的疗效研究

Research on the effect of nanofat combined with granular fat injection in the treatment of mixed dark circle at lower eyelid

目的探讨皮下注射纳米脂肪联合泪槽凹陷区域注射颗粒脂肪改善下睑混合型黑眼圈的临床疗效,以及采用L^*a^*b^*值客观评价下睑黑眼圈区域皮肤颜色改善程度的可行性。方法以华中科技大学同济医学院附属协和医院整形外科2017年11月至2018年8月收治的14例混合型黑眼圈患者作为研究对象,均为女性,年龄21~46岁。选取大腿或腹部作为脂肪供区,常规获取颗粒脂肪,将自体颗粒脂肪填充至泪槽凹陷区域。将制备的纳米脂肪注射至下睑黑眼圈区域皮下层。在同等曝光条件及相同室温等环境下拍摄患者术前及术后6个月照片,通过Photoshop CS7校正曝光度,再用Image J 64软件测量图片中黑眼圈注射区域皮肤L^*a^*b^*值,应用SPSS 20.0对数据行统计学分析,采用配对t检验进行比较,P<0.05为差异有统计学意义。结果所有患者随访至术后6个月,在1次注射后可达到较理想的效果,患者总体满意率达78.6%(11/14)。14例患者下睑黑眼圈色泽、皮肤细小皱纹均较术前改善,注射区域轮廓光滑,未出现明显并发症。术后6个月照片中下睑黑眼圈区域皮肤L^*值为55.13±5.56,较术前的48.23±5.63增加了7.74±2.39,差异有统计学意义(t=12.089,P=0.00);术后6个月a^*值为14.68±2.84,较术前的14.79±3.04减少了0.11±0.60,差异无统计学意义(t=-0.71,P=0.49);术后6个月b^*值为19.77±3.45,较术前的19.50±3.45增加了0.27±1.03,差异无统计学意义(t=0.98,P=0.35)。结论皮下注射纳米脂肪联合泪槽区域注射颗粒脂肪治疗下睑混合型黑眼圈有效果;L^*a^*b^*值能客观评价下睑黑眼圈区域皮肤颜色的改善程度。

Objective To investigate the clinical effect of subcutaneous injection of nanofat combined with autologous fat into tear trough deformity to improve the mixed dark circle at lower eyelid,and the feasibility of using L^*a^*b^*value to objectively evaluate the improvement of skin color at the lower eyelid with dark circle.Methods A total of 14 patients with the mixed dark circle at lower eyelid,admitted by Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from November 2017 to August 2018 were selected.They were all female,aged between 21 and 46 years old.Thigh or abdomen was selected as the fat donor area.Autologous fat was filled into the tear trough deformity.The prepared nanofat was injected into the subcutaneous layer of the lower eyelid with dark circle.Photoes were taken under the same condition and same room temperature for patients before operation and 6 months after operation.Photoshop,CS7 exposure correction,as well as 64 Image J software measurement were adopted to evaluate the skin L^*a^*b^*value at dark circle of lower eyelid.SPSS 20.0 rows of data statistical analysis was applied with paired t test(P<0.05).Results All patients were followed up for 6 months after the operation,and a satisfactory effect was achieved after one injection,with an overall satisfaction rate of 78.6%(11/14).The color and skin fine wrinkles at the dark circle of the lower eyelid were improved in 14 patients,and the contour of the injection area was smooth without obvious complications.6 months after the operation,the L^*value of the skin at the lower eyelid with dark circle was 55.13±5.56,which was 7.74±2.39 higher than the preoperative value of 48.23±5.63,showing significant difference(t=12.089,P=0.00).Six months after surgery,the a^*value was 14.68±2.84,which decreased by 0.11±0.60 compared with 14.79±3.04 before surgery,showing no statistically difference(t=-0.71,P=0.49).Six months after surgery,the b^*value was 19.77±3.45,which increased by 0.27±1.03 compared with 19.50±3.45 before surgery,showing no statistical difference(t=0.98,P=0.35).Conclusions Subcutaneous injection of nanofat combined with autologous fat injection for tear trough deformity is effective in the treatment of lower eyelid with mixed dark circle.The L^*a^*b^*value can objectively evaluate the improvement of skin color at the lower eyelid with dark circle.