苏钰 王华军 袁斯明

[摘要]目的：探究脂肪組织源性干细胞（Adipose derived stem cells，ADSCs）辅助脂肪颗粒移植（Cell-assisted lipotransfer，CAL）在填充面部软组织凹陷中的临床应用。方法：选取2015年5月-2018年5月经笔者医院诊治的面部软组织凹陷患者86例，根据随机数字表法分为研究组和对照组，各43例。两组患者均采用局部肿胀吸脂术于下腹部抽取自体脂肪颗粒组织。研究组经分离、纯化后获取的ADSCs与脂肪颗粒混合均匀后以填充面部软组织凹陷;对照组单纯采用脂肪颗粒移植治疗。观察两组患者术后临床疗效并调查其满意度，比较两组患者术后并发症发生情况。结果：研究组患者满意度为100.00%（43/43）显著高于对照组79.07%（34/43），术后并发症发生率为0.00%显著低于对照组的37.21%（16/43），差异均有统计学意义（P<0.05）。结论：CAL可通过提高自体脂肪颗粒存活率以达到较好的面部软组织凹陷填充效果，对患者面部损伤小且术后并发症少，在面部软组织凹陷的治疗中具有较好的临床应用价值。

[关键词]脂肪组织源性干细胞;自体脂肪颗粒移植;填充;软组织凹陷;面部;疗效

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2019）07-0082-03

Clinical Efficacy of ADSCs-assisted Fat Granule Transplantation in Filling Facial Soft Tissue Depression

SU Yu，WANG Hua-jun，YUAN Si-ming

（Department of Burn and Plastic Surgery，Nanjing General Hospital of War Zone，Nanjing 210016，Jiangsu，China）

Abstract： Objective  To investigate the clinical application of adipose tissue-derived stem cells （ADSCs） assisted fat granule transplantation （CAL） in filling facial soft tissue depression. Methods  86 patients with facial soft tissue depression who were treated by our hospital from May 2015 to May 2018 were enrolled. The patients were divided into study group and control group according to the random number table method， and 43 cases were in both groups. Both groups of patients used local swelling liposuction to extract autologous fat granule tissue in the lower abdomen. The ADSCs obtained after separation and purification in the research group were uniformly mixed with the fat particles to fill the facial soft tissue depression， the control group was treated with fat granule transplantation alone. The clinical efficacy and satisfaction of the patients were observed， and the incidence of postoperative complications was compared between the two groups.  Results The patient satisfaction rate of the study group was 100.00% （43/43）， which was significantly higher than that of the control group[79.07% （34/43）]， the postoperative complication rate was 0.00% in the study group， which was significantly lower than that of the control group[37.21% （16/43）]， the differences were statistically significant（P<0.05）. Conclusion  CAL can improve the filling effect of facial soft tissue sag by increasing the survival rate of autologous fat granules， it has small facial damage and less postoperative complications， and has good clinical application value in the treatment of facial soft tissue depression.

Key words： adipose tissue-derived stem cells; autologous fat granule transplantation; filling; soft tissue depression; face; efficacy

面部软组织凹陷主要由半侧颜面萎缩症及第二腮弓畸形及创伤导致，严重影响患者容貌及心理。降低颗粒脂肪注射移植后的脂肪吸收率，保持移植脂肪组织的体积是治疗面部软组织凹陷的关键。自体组织移植填充、人工合成材料填充和生物材料填充是临床主要使用的整复方法，其中自体脂肪移植在面部软组织凹陷中的应用日益广泛，但脂肪移植后出现坏死、炎症和高比率的脂肪吸收等现象，其中血液微循环不足是造成脂肪流失的主要原因[1-3]。……