受区肿胀预扩张技术在自体脂肪面部移植中的临床应用

Clinical application of recipient-site pre-expansion via tumescent anesthesia applied in facial fat grafting

目的 探讨受区肿胀预扩张技术在自体脂肪面部移植术中的临床效果和安全性.方法 采用受区肿胀预扩张技术行自体脂肪面部移植术,应用高频超声记录受术者手术前后定点的软组织厚度、血流信号及受区变化,使用SPSS 11.5进行统计分析,各时间点脂肪移植物存活率比较采用Kruskal-Wallis H检验;血流信号面积比率采用方差分析,患者术后满意率及疼痛评估采用均值统计数值.结果 14例受术者术后凹陷部位改善明显.高频超声示脂肪受区定点软组织厚度变化率,术后1、3及6个月的中位数及四分位数间距分别为70.1％(53.85％)、56.4％(51.95％)、16.7％(35.8％),3组数据比较,差异具有统计学意义(H=1.4×108,P<0.05).术前、术后24 h、7 d、1、3及6个月同一横截面积血流信号面积分别为(3.97±0.84)‰、(2.21±0.55)‰、(6.89±2.39)‰、(14.61±4.66)‰、(9.39±3.94)‰和(15.87±3.02)‰,6组数据比较,差异具有统计学意义(F=3.471,P<0.05).随访期间无一例出现并发症;受术者满意度高;术后止痛效果满意.结论本研究中,受区肿胀预扩张技术在面部脂肪移植中效果确切,并发症发生率低.

Objective To evaluate the clinical efficacy and safety of recipient-site pre-expansion via tumescent anesthesia in facial fat grafting .Methods Facial fat grafting was operated through the technology of recipient-site pre-expansion via tumescent anesthesia .The high-frequency ultrasonography was used to record the changes of soft tissue thickness , blood flow signal and transplant area in certain-points.Theresult were analyzed by SPSS 11.5.The survival rates of fat grafting were compared by Kruskal-Wallis H test.The area of soft tissue blood flow signals were analyzed by variance analysis .The patients' postoperative satisfaction rates and pain were evaluated by mean value .Results 14 cases were treated , with obvious improvement .Results of high frequency ultrasonography showed the median and quartile spacing of the soft tissue thickness was 70.1％(53.85％), 56.4％(51.95％), and 16.7％in the first month, third month and the sixth month after operation , separately.The difference between the three groups was statistically significant (H=1.4 ×108, P<0.05).The area of soft tissue blood flow signals was(3.97 ±0.84)‰,(2.21 ±0.55)‰,(6.89 ±2.39)‰,(14.61 ±4.66)‰,(9.39 ±3.94)‰, (15.87 ±3.02)‰before the operation, 24 hours, the first month, third month and the sixth month after operation,separately.The difference between the six groups were statistically significant (F=3.471, P <0.05).No complication occurred in the following-up period.Patients were satisfied with the pain relief. Conclusions It is safe and effective to apply recipient-site pre-expansion via tumescent anesthesia in fat grafting.