自体脂肪颗粒移植矫治上睑凹陷畸形28例体会.docVIP

自体脂肪颗粒移植矫治上睑凹陷畸形28例体会[摘要]目的:总结28例自体脂肪颗粒注射移植矫治上睑凹陷畸形的治疗体会。方法:采用注射器法抽取腹部或大腿内侧部位脂肪颗粒,经清洗、过滤及纯化后以1ml注射器移植于上睑凹陷区,术中术后局部按摩。结果:本组共28例,25例一次注射充填后形态满意,3例有部分吸收,半年后行二次注射。结论:自体颗粒脂肪移植取得成功的关键在于术前合理设计、术中正确地抽吸注射技术及术后良好的局部处理。 [关键词]自体脂肪移植;脂肪注射;上睑凹陷 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)04-0502-03 Correction of upper eyelids excavation via autologous fat granule transplantation in 28 cases LIU Zhi-kun, ZENG Jian, YANG Feng, JIANG Bin, ZHOU Hai-yan, DENG mei-xiang (Medical Cosmetic Department, the Second Affiliated Hospital, University of South China, Hengyang 421001, Hunan, China) Abstract:Objective To summarize the experience of correction of upper eyelids excavation via autologous fat granule transplantation in 28 cases.MethodsFat granules was harvested from abdomen and medial thigh with injector, then purged, filtered, pured and injected into the upper eyelids excavation area. Local massage in operation and postoperation.ResultsIn 28 cases, the injected fat granule was partly absorbed in 2 patients, reinjected after six months. The other patients satisfied with the results.ConclusionTo attach successful autologous fat granule transplantation, the key points are equitable design preoperation, the correct liposuction and injection in operation and good local treatment postoperation. Key words:autologous fat transplantation; fat injection; upper eyelids excavation 自体脂肪颗粒移植充填治疗面部软组织凹陷在我国已经有10余年的发展,技术不断进步成熟,手术经验积累也逐渐丰富,已经成为矫治面部凹陷畸形的常规手术方法[1]。上睑凹陷畸形是中老年人群中较为常见的眼部衰老征象之一。我科2007年12月～2009年8月, 采用自体脂肪颗粒移植矫正上睑凹陷畸形共28例, 取得了令人满意的临床效果,术后随访3～12个月效果稳定,现总结如下。 1资料和方法 1.1 临床资料:本组共28例,均为女性,年龄36～57岁,平均年龄48岁,23例为原发性双上睑凹陷,3例为重睑术中去除上睑眶隔内脂肪过多而造成双上睑凹陷,2例为眼球摘除义眼充填术后上睑眼窝凹陷。充填自体脂肪颗粒每侧1.8～3.2ml,平均约2.6ml。 1.2手术方法 1.2.1 脂肪颗粒采集方法: 本组所需脂肪颗粒均采自腹部或大腿内侧部位,操作方便。术前根据各部位脂肪堆积量精确设计脂肪颗粒抽取区域,以记号笔标识后碘酊固定。手术区域常规消毒、铺巾后,采用肿胀麻醉技术,按500ml生理盐水+2%盐酸利多卡因15ml+肾上腺素1mg比例配制肿胀麻醉液,于供区行肿胀麻醉, 麻醉生效后用20ml注射器接针径1.5mm脂肪抽吸针,经脐旁及双侧腹股沟抽取腹部浅层及双大腿内侧深层脂肪颗粒混悬液置于消毒碗中,将其中条索状、纤维隔样组织用长针挑除,然后以20ml注射器吸取混悬液,采用“静置悬浮法”,以庆大霉素生理