摘要
目的:通过尸头解剖探索颞部主要脂肪室的解剖层次和自体脂肪的填充入路,以及临床回顾性分析大容量脂肪填充颞部的效果。方法:通过对5具新鲜尸头(10侧,年龄25~50岁,男性2具,女性3具)的颞部脂肪室解剖,明确颞部脂肪室大容量填充的安全、稳定的层次。回顾性分析2020年1月至2021年1月中南大学湘雅二医院整形美容(烧伤)外科及长沙美莱医疗美容医院收治的颞部脂肪移植患者资料。按照脂肪填充注射层次和量,将纳入患者分为大容量组和常规组。大容量组需要满足填充层次至少包括3层脂肪室,填充量一般大于15 ml;常规组仅填充1~2个层次,为皮下脂肪和颞中筋膜,填充量一般小于15 ml。术中从额部发际线内进针,针对主要的脂肪室进行脂肪注射。对比研究2组的单侧注射剂量及术后3个月的手术医师Likert量表评分、患者满意度等指标。术后3个月随访评估时,以首次手术中利用剩余脂肪制作的脂肪来源干细胞基质胶(SVF-gel)进行局部微调。结果:解剖研究发现颞部存在浅、中、深3层主要脂肪室,即皮下脂肪层、颞浅脂肪垫及颞深脂肪垫;年老患者颞部的皮下脂肪菲薄,颞浅脂肪垫及颞深脂肪垫萎缩明显,对颞部浅层软组织支撑作用明显减弱,颞深脂肪垫可见明显萎缩伴一定程度的下移。临床研究共纳入50例接受双侧颞部脂肪移植的女性患者,常规组和大容量组各25例。常规组年龄为(32.7±7.1)岁,身体质量指数(BMI)为(20.2±1.9)kg/m 2;大容量组年龄为(32.5±8.3)岁,BMI为(19.8±2.0)kg/m 2;两组的年龄和BMI的差异均无统计学意义(P>0.05)。大容量组填充剂量为(19.66±4.61)ml/侧,手术医师Likert量表评分为(4.32±0.63)分,患者满意率为92.0%(23/25);常规组填充剂量为(11.06±2.62)ml/侧,手术医师Likert量表评分为(3.32±0.80)分,患者满意率为68.0%(17/25);这3个指标在2组间的差异均有统计学意义(P<0.05)。大容量组
Objective To explore the anatomical levels and injection approaches of the major temporal fat compartments through cadaveric head dissection and to analyze the efficacy of high-volume fat transplantation of the temporal region in a clinical retrospective research.MethodsTo clarify the safe and stable levels of high-volume filling of the temporal fat compartment by dissecting the temporal fat compartment of 5 fresh cadaveric heads(10 sides,25-50 years old,2 males,3 females).We retrospectively analyzed the data of patients with temporal fat transplantation admitted to the Second Xiangya Hospital of Central South University and Changsha Mylike Medical Cosmetic Hospital from January 2020 to January 2021.According to the levels and volume of fat filling injection,the patients were divided into large-volume group and conventional group.In the large-volume group the patients were filled with at least three fat compartments with a filling volume of more than 15 ml,while in the conventional group only with 1 to 2 layers,which were the subcutaneous fat and the middle temporal fascia,and the filling volume was generally less than 15 ml.Fat injections were performed with a needle entry within the frontal hairline,targeting the main fat compartments.We compared and studied the mean injection volume per side,postoperative surgeon’s Likert scale score,patient satisfaction and other indicators in the two groups of cases.Stromal vascular fraction-gel(SVF-gel),which was made from surplus fat during the initial operation,was used to locally fine-tune the effect at the 3-month follow-up evaluation.ResultsThe anatomical study revealed the existence of three main fat compartments in the temporal region:subcutaneous fat layer,superficial and deep temporal fat pad.In the elderly cadavers,the subcutaneous fat was thin,the superficial temporal fat pad and deep temporal fat pad atrophied obviously,and the supporting effect on temporal superficial soft tissue was significantly weakened.The deep temporal fat pad showed obvious atrophy with
作者
葛皓杰
林彪斌
方柏荣
Ge Haojie;Lin Biaobin;Fang Bairong(Department of Plastic and Aesthetic(Burn)Surgery,the Second Xiangya Hospital,Central South University,Changsha 410011,China;Changsha Mylike Medical Cosmetic Hospital,Changsha 410011,China)
出处
《中华整形外科杂志》
CSCD
2023年第6期646-654,共9页
Chinese Journal of Plastic Surgery
关键词
解剖学
脂肪室
脂肪移植
颞部年轻化
Anatomy
Fat compartment
Fat grafting
Temporal rejuvenation
