摘要
目的:研究面部脂肪室靶向移植的解剖入路,并探讨其应用于临床的效果。方法:通过解剖8具(16侧)尸体,明确脂肪室边界和相邻血管神经的走行,根据解剖结果分析确定靶向脂肪移植的推荐进针点和入路。对2017年6月至2019年6月上海交通大学医学院附属第九人民医院收治的46例要求改善面部凹陷或行面部年轻化治疗的女性患者,采用靶向移植的入路进行颞部和面中部脂肪填充,患者年龄(36.1±7.6)岁。记录移植的脂肪量。术后3个月调查患者满意度,根据移植部位存活情况在3~6个月行二次填充。在移植末次6个月后,采用三维扫描仪评估脂肪存活率等。结果:解剖研究发现在额部存在皮下浅层脂肪室,颞部和面中部存在深、浅2层脂肪室结构,根据解剖特点,建立了以额部发际内和口角内侧黏膜等为进针点,针对面部深、浅脂肪室位置的靶向脂肪移植技术。临床46例患者颞部移植脂肪量为(17.84±8.47) ml,面中部为(26.81±10.36) ml,移植末次6个月后三维扫描结果显示,颞部脂肪留存(11.2±2.44) ml,存活率63%;面中部留存(16.09±4.48) ml,存活率60%。患者总体满意率93%(43/46)。随访期间所有患者术后无感染、液化、栓塞以及神经损伤等并发症出现。结论:面部靶向脂肪移植的解剖入路的明确,提升了面部脂肪注射的有效性和安全性。
Objective The purpose of this study is to establish the trajectory of targeted grafting for facial fat compartment based on anatomical research,and then bring it to clinical practice.Methods The boundary of fat compartment and the relationship of adjacent vessel and nerve were clarified through autopsy.The recommended injection points and trajectory for targeted fat grafting were established on the anatomical findings.Retrospective clinical data of facial rejuvenation of 46 patients through targeted fat grafting were collected from June 2017 to June 2019 in Shanghai Ninth People’s Hospital.The result of 3D scanning were analyzed to evaluate the survival rate of fat grafts.Results There were subcutaneous superficial fat compartments in the frontal region,and there were both deep and superficial fat compartments in the temporal and middle face.According to the anatomical characteristics,a targeted fat grafting technique was established with the frontal hairline and the oral commissure corner mucosa as the entry points.In the clinical study,46 patients were evaluated by 3D scanning 6 months after the last fat grafting.The amount of fat grafts in the temporal region was(17.84±8.47)ml and(11.2±2.44)ml was left after operation,and the survival rate was 63%.The amount of fat grafts in mid-face was(26.81±10.36)ml and(16.09±4.48)ml was left after operation,and the survival rate was 60%.Overall satisfaction rate of patients was 93%(43/46).Conclusions Compartment-based targeted fat grafting is an accurate injection method,which meets the requirement of physiological augmentation.The trajectory of targeted fat grafting will further improve the efficacy and safety of injection.
作者
程辰
王文进
黄如林
周佳
赵珮娟
朱一佳
李青峰
谢芸
Cheng Chen;Wang Wenjin;Huang Rulin;Zhou Jia;Zhao Peijuan;Zhu Yijia;Li Qingfeng;Xie Yun(Department of Plastic&Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第8期834-840,共7页
Chinese Journal of Plastic Surgery
基金
国家自然科学基金(81701917)
上海浦江人才计划(2019PJD024)
交通大学医学院双百人计划(20191916)
九院临床研究助推计划资助(JYLJ004)。
关键词
脂肪组织
脂肪室
解剖学
脂肪移植
靶向治疗
Adipose tissue
Fat compartment
Anatomy
Fat grafting
Targeted therapy
