陈敏亮

[摘要]脂肪移植的临床应用正显示出前所未有的良好前景，譬如改善各类自体组织移植的存活率、促进难愈性创面愈合、改善瘢痕增生、促进毛发再生、抗皮肤衰老等。但是脂肪移植仍存在存活率低、需要二次手术补充;同时移植的方式和技术也会极大影响脂肪的存活率等问题。目前，整形美容修复领域对脂肪干细胞（adipose stem cells，ASCs）的研究集中于促进移植脂肪成活、改善局部软组织缺损如乳房再造、面部塑形等;ASCs辅助脂肪移植减少皱纹;改善皮肤溃疡、糖尿病足等。对于脂肪冷冻保存的技术和冷冻保护剂的研制也将是一个新的研究热点。此外，对于脂肪移植并发症防控及救治技术的探索，也是未来研究的重点。

[关键词]脂肪移植;脂肪来源干细胞;冷冻保存;并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2019）02-0002-02

Abstract： The clinical application of fat transplantation is showing unprecedented prospects. Autologous fat grating has been used in various fields， such as improving the survival rate of all kinds of autologous tissue transplantation， healing the refractory wounds and hyperplastic scar， promoting hair regeneration， anti-aging skin and so on. However， the survival rate of fat transplantation is still low so that many cases require secondary surgery. Moreover， the survival rate also depends on the method and technology of fat transplantation. Currently， the research process on ASCs in plastic surgery focuses on the following aspects. Firstly， the survival rate of transplanted fat and soft tissue defects， including breast reconstruction and facial remodeling. Secondly， reducing wrinkles by ASCs assisted fat transplantation. Thirdly， healing skin ulcer and diabetic foot. Fourthly， the technology of fat cryopreservation and the development of cryoprotectant. In addition， the exploration of prevention and treatment of fat transplantation complications is also the focus of future research.

Key words： fat transplantation; adipose-derived stem cells; cryopreservation; complications

隨着人们生活水平提高和医学发展，脂肪移植的适应证正稳步增多，脂肪抽吸成为当今世界范围内最流行的整形美容外科手术之一，抽吸的脂肪不仅能够用来填充矫治因疾病、创伤或衰老等导致的组织容量缺损，还能被制备成多种形式而扩大应用范围，成为整形美容外科研究的新方向。

1  移植脂肪存活机制研究及进展

目前脂肪移植仍存在存活率低、需要二次手术补充等问题[1]。2007年Yoshimura等[2]报道了将富含脂肪干细胞的基质血管成分（stromal vascular fraction，SVF）辅助脂肪移植应用于隆乳手术，取得了良好的效果，并且在2009年[3]首次提出自体细胞辅助脂肪移植技术（cell-assisted lipotransfer，CAL），即将自体ASCs与脂肪细胞混合，联合注射移植。……