陈荣亮 张昕桐 孙榕呈 梁军

[摘要]目的：探究高度濃缩生长因子纤维蛋白（Concentrated growth factor，CGF）联合自体脂肪颗粒移植修复面部凹陷畸形的疗效及安全性。方法：选取2017年1月-2020年1月笔者医院收治的83例面部凹陷畸形患者，按照随机数字表法分为实验组（n=42）和对照组（n=41），对照组采用自体脂肪颗粒移植修复，实验组采用CGF联合自体脂肪颗粒修复，比较两组术后脂肪植入厚度、液化灶发生率、植入物存活率、二次手术率及满意度。结果：术后1个月、3个月、6个月两组脂肪植入厚度均有不同程度下降，但实验组均高于对照组，差异具有统计学意义（P<0.05）。术后1个月实验组发生液化灶比例低于对照组，差异具有统计学意义（P<0.05）。与术后1个月相比，术后3个月、6个月两组植入物存活率均降低，但同组间术后3个月与术后6个月存活率比较差异无统计学意义（P>0.05）;各时间点实验组植入脂肪存活率均高于对照组，差异具有统计学意义（P<0.05）。实验组二次手术率低于对照组，满意度高于对照组，差异具有统计学意义（P<0.05）。结论：高度浓缩生长因子纤维蛋白联合自体脂肪颗粒移植修复面部凹陷畸形能有效改善移植脂肪成活率，降低液化灶率和二次手术率，提高患者满意度。

[关键词]高度浓缩生长因子纤维蛋白;自体脂肪颗粒移植;面部凹陷畸形;脂肪存活率;液化灶

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）06-0013-04

Efficacy and Safety of Concentrated Growth Factor Combined with Autologous Fat Granule Transplantation to Repair Facial Depression

CHEN Rong-liang，ZHANG Xin-tong，SUN Rong-cheng，LIANG Jun

（Department of Cosmetic Surgery，Meilai Medical Aesthetic Hospital，Chengdu 610000，Sichuan，China）

Abstract： Objective  To explore the efficacy and safety of concentrated growth factor （CGF） combined with autologous fat granule transplantation in repairing facial depression deformities. Methods  A total of 83 patients with facial depression deformity admitted to our hospital from January 2017 to January 2020 were selected and divided into the experimental group （n=42） and the control group （n=41） according to the random number table method. The control group received autologous fat granule transplantation restoration， and the experimental group received CGF combined with autologous fat granule restoration. The thickness of fat implantation， the incidence of liquefaction foci， implant survival rate， secondary operation rate and satisfaction degree were compared between the two groups. Results  The thickness of fat implantation decreased in the two groups at 1 month， 3 months and 6 months after operation， but the experimental group was higher than that of the control group， and the differences were statistically significant （P<0.05）. One month after operation， the proportion of liquefaction focus in the experimental group was lower than that in the control group （P<0.05）. Compared with one month after operation， the implant survival rates of the two groups at 3 months and 6 months after operation were decreased， but there was no significant difference between the two groups at 3 months and 6 months after operation （P>0.05）. The survival rate of the experimental group was higher than that of the control group at each time point （P<0.05）. The second operation rate of the experimental group was lower than that of the control group， and the satisfaction of the experimental group was higher than that of the control group （P<0.05）. Conclusion  Concentrated growth factor combined with autologous fat granule transplantation in facial depression can effectively improve the survival rate of transplanted fat， reduce the rate of liquefaction foci and the rate of secondary operations， and improve patient satisfaction.

Key words： concentrated growth factor（CGF）; autologous fat granule transplantation; facial depression deformity; fat survival rate; liquefaction foci

面部凹陷畸形是局部组织萎缩或缺损引发的面部容积性改变，可由面颅骨发育不良、感染、衰老、肿瘤切除等多种因素引发，可对患者外观和工作生活造成较大影响[1]。传统治疗方式多采用填充和自体组织移植，人工填充原理简单、有效，但可能带来排异反应、效果不够持久等问题;自体组织填充主要采用扩张皮瓣、脂肪组织瓣等修复方式，存在供区创伤面积大、手术并发症多等问题[2-3]。而自体脂肪作为一种软组织填充物，因生物相容性好、取材广泛、创伤小等优点，目前已经成为临床面部软组织损伤最常用的治疗方法之一[4]。但不同患者脂肪吸收程度不同而经常需要多次手术补充容量是脂肪移植最常见问题，且多次进行有创操作可造成患者对治疗排斥，不利于术后顺利康复[5]。……