双平面多隧道自体颗粒脂肪移植在额颞部凹陷中临床应用.doc

双平面多隧道自体颗粒脂肪移植在额颞部凹陷中临床应用[摘要]目的:探讨应用自体颗粒脂肪双平面、多隧道的方法游离移植矫治额颞部凹陷的临床效果。方法:采用自体颗粒脂肪移植矫正额颞部凹陷,通过注射麻醉液预先估计填充量,受区皮下预处理形成颞浅筋膜浅层和深层两个平面及多个隧道。以注射器吸取大腿颗粒脂肪,经纯化后,分层次超量注射充填额颞部凹陷。结果:本组32例患者术后未发现有感染、坏死及液化等并发症。除3例进行二次注射外,其余均为一次性注射。充填后原凹陷部位丰满,局部无硬结,质感和外形好,与周围组织无界限。结论:采用双平面、多隧道的方法行自体脂肪颗粒移植矫治额颞部的凹陷,塑形容易,其形态质感与周围组织一致,无明显界限,且方法简便,值得临床推广应用。 [关键词]脂肪组织;移植;颞部;自体 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)04-0484-02 Autologous fat granule graft of multilple tubes and double layers in the correction of fronto-temporal depression PAN Wei-feng (Depatment of AestheticPlastic Surgery, Shuguang Medical Hospital,Guangzhou 510403,Guangdong,China) Abstract:ObjectiveTo explore the clinical effect on the fronto-temporal augmentation by the free transplantation of autologous fat granule graft of multilple tubes and double layer.MethodsThe amount of soft-tissue defect was estimated by the volume of the injected lacal anaesthetic liquid. Many tubes were formed subcutaneously in the region to be augmented.The thigh fat granule was aspirated with common syringe and then reinjected into those tubes and into or under the muscle of the fronto-temporal region after be concentrated.ResultsAll the 32 patients were involved in the analysis of result.NO infection,necrosis,lique faction,others were all corrected by one time with no complication.With the follow-up with 3to 13 months. All the cases were satisfying with external shape. Key words:adipose tissue;transplantation;pars temporalis;autoallergic 额颞部凹陷是一种常见的面部畸形,使用人工材料的方法进行充填额颞部会引起额颞部充填部位的异物感以及假体的排斥或移位等情况[1]。自体颗粒脂肪注射移植是将抽吸所得的自体纯化颗粒脂肪注射到软组织缺损部位,从而使受区达到丰满塑形的效果[2-4]。笔者自2008年6月～2009年10月采用双平面多隧道的自体颗粒脂肪移植的方法治疗额颞部凹陷32例,取得了满意的效果,现报道如下。 1资料和方法 1.1 临床资料:本组共32例,均为女性。年龄19～48岁,平均年龄29.4岁。其中双侧凹陷30例,单侧凹陷2例。自体脂肪供区均为大腿的内、外侧。每个部位注射脂肪量5～26ml,平均15.2ml。 1.2 手术方法 1.2.1术前检查:术前仔细测量受区部位凹陷范围与程度,术者与患者充分交流确认填充部位的范围及厚度,美蓝标记其范围,估计所需脂肪量。 1.2.2 抽吸脂肪颗粒:取大腿内、外侧皮下脂肪作移植供区,因大腿处脂肪颗粒较腹部等其他部位纯度高,纤维组织等含量较少,术后容易成活,用0.9%生理盐水500 ml+2%利多卡因15ml+0.1%肾上腺素0.3ml配成局部肿胀麻药, 在预定