富血小板血浆联合自体脂肪移植多层次多隧道注射治疗哺乳后乳腺萎缩的临床观察

Clinical Observation of Multi-level and Multi-tunnel Injection of Platelet-rich Plasma(PRP)Combined with Autologous Fat Transplantation in the Treatment of Breast Atrophy after Breast-feeding

目的:探讨富血小板血浆(Platelet-rich plasma,PRP)结合自体脂肪移植多层次、多隧道注射治疗哺乳后乳腺萎缩的临床疗效。方法:2016年3月-2018年3月,共72例要求改善哺乳后乳腺萎缩的女性就医者,均采用PRP结合自体脂肪移植多层次、多隧道注射隆乳。抽取外周静脉血制备PRP,于大腿及臀、腹部获取自体脂肪颗粒并静置纯化,以1:20比例混合PRP与自体脂肪颗粒,将PRP-脂肪颗粒多隧道注射于乳腺后、胸大肌后及皮下,每次单侧注射量约150~200ml,间隔半年左右再次注射,视个人情况及要求注射1~2次。结果:术后随访1~3年,14例首次注射术后半年仍觉不够饱满,进行二次补充注射后效果满意;4例首次注射后3个月出现局部少量脂肪结节,局部按摩及热敷处理后结节消失;其余就医者均恢复良好,乳房体积明显增加,形态挺拔自然,均未出现术后移植脂肪感染、坏死、血肿形成等并发症。术前测量平均胸围值为(88±1.5)cm,术后6个月测量平均胸围值为(93±1.2)cm,术后12个月为(92±1.1)cm,术前与术后6个月、12个月比较差异具有统计学意义(P<0.05)。结论:PRP结合自体脂肪移植多层次、多隧道注射治疗哺乳后乳腺萎缩临床疗效良好,并发症少,术后乳房形态挺拔,手感自然,值得临床应用。

Objective To explore the effect of multi-level and multi-tunnel injection of platelet-rich plasma(PRP)combined with autologous fat transplantation in the treatment of breast atrophy after breast-feeding.Methods From March 2016 to March 2018,a total of 72 cases of female patients demanding improvement of breast atrophy after breast-feeding were augmented by PRP combined with autologous fat transplantation through multi-level and multi-tunnel injection.Peripheral venous blood was extracted to prepare PRP.Autologous fat particles were obtained from thighs,buttocks and abdomen and purifi ed statically.PRP and autologous fat particles were mixed at a ratio of 1:20.Multiple tunnels were injected into the posterior breast,the posterior pectoralis major muscle and subcutaneously.The dose of each single injection was about 150-200ml.The injection was repeated at intervals of about half a year.The injection was 1-2 times depending on personal condition and requirement.Results Following up for 1 to 3 years,fourteen cases still felt unsatisfactory half a year after the fi rst injection,and the effect was satisfactory after the second supplementary injection.Local fat nodules appeared in 4 cases 3 months after the first injection,and disappeared after local massage and hot compress treatment.The rest of the patients recovered well,the volume of breast increased signifi cantly,the shape was straight and natural,and there were no complications such as fat infection,necrosis and hematoma formation after transplantation.All patients no obvious calcifi cation was found in mammogram one year after operation.The average chest circumference was(88±1.5)cm before operation,and the average chest circumference was(93±1.2)cm after 6 months,the average chest circumference was(92±1.1)cm after 12 months of operation.The difference of chest circumference before and after operation was statistically significant(P<0.05).Conclusion PRP combined with autologous fat transplantation with multi-level and multi-tunnel injection has a good clinical effect in treating breast atrophy after breast-feeding,with fewer complications.The breast shape after operation is straight and straight,and the feeling is natural.It is worthy of clinical application.