• 中山大學(xué)第一附屬醫(yī)院整形修復(fù)外科（廣州，510080）;

目的 通過(guò)與Coleman 方法比較，探討軸狀脂肪移植方法的可行性。 方法 采用Coleman 方法及軸狀脂肪移植方法，分別于11 例擬行頭面部脂肪移植患者的下腹部抽取脂肪。取3 ～ 4 周齡免疫缺陷裸鼠48 只，雌雄不限，體重8.6 ～ 12.2 g；隨機(jī)分為兩組，每組24 只。以背部皮下間隙為移植受區(qū)，實(shí)驗(yàn)組移植0.5 mL 軸狀脂肪移植方法獲得的人體脂肪組織，對(duì)照組移植0.5 mL Coleman 方法獲得的人體脂肪組織。術(shù)后大體觀察實(shí)驗(yàn)動(dòng)物背部外觀，于1、2、4、8 周兩組隨機(jī)處死6 只裸鼠，取出背部皮下移植脂肪進(jìn)行大體、組織學(xué)及免疫組織化學(xué)染色觀察，并于取出脂肪前后對(duì)裸鼠稱(chēng)重，計(jì)算移植脂肪重量。脂肪抽取術(shù)后即刻取脂肪組織進(jìn)行葡萄糖轉(zhuǎn)移實(shí)驗(yàn)和脂肪細(xì)胞活性測(cè)定。2010 年5 月－ 2011年10 月，臨床應(yīng)用面部軸狀脂肪移植治療11 例局部凹陷性畸形。 結(jié)果 術(shù)后實(shí)驗(yàn)組裸鼠背部隆起樣外觀基本維持，對(duì)照組2 周時(shí)已趨于平坦。兩組植入脂肪重量相似（P  gt; 0.05）；除術(shù)后2 周外，其余各時(shí)間點(diǎn)實(shí)驗(yàn)組殘余脂肪重量均顯著高于對(duì)照組（P  lt; 0.05）。組織學(xué)觀察示實(shí)驗(yàn)組細(xì)胞形態(tài)保持良好，血管分布均勻；對(duì)照組細(xì)胞破壞再吸收顯著，血管集中分布于移植組織邊緣。術(shù)后實(shí)驗(yàn)組完整脂肪細(xì)胞計(jì)數(shù)均明顯多于對(duì)照組，除術(shù)后2 周外其余各時(shí)間點(diǎn)組間比較差異均有統(tǒng)計(jì)學(xué)意義（P  lt; 0.05）。實(shí)驗(yàn)組毛細(xì)血管計(jì)數(shù)均少于對(duì)照組，術(shù)后1、2 周比較差異有統(tǒng)計(jì)學(xué)意義（P  lt; 0.05），但4、8 周時(shí)差異無(wú)統(tǒng)計(jì)學(xué)意義（P  gt; 0.05）。軸狀脂肪移植方法抽取的脂肪組織葡萄糖轉(zhuǎn)移量為（1.462 ± 0.080）mmol/L，顯著高于Coleman 方法抽取的脂肪組織（1.153 ± 0.199）mmol/L（t=3.317，Ρ=0.021）；且軸狀脂肪移植方法抽取的脂肪組織細(xì)胞活性更佳。臨床應(yīng)用患者均獲隨訪，隨訪時(shí)間2 ～ 9 個(gè)月；隨訪期間受區(qū)未見(jiàn)明顯萎縮及塌陷。 結(jié)論 與Coleman 方法比較，軸狀脂肪移植方法獲得的脂肪組織可保持原結(jié)構(gòu)和良好活性，移植術(shù)后能更早與受區(qū)建立血液循環(huán)，術(shù)后組織再吸收率低，形態(tài)維持時(shí)間長(zhǎng)。

引用本文： 秦王馳,許揚(yáng)濱,劉祥廈,許澍洽. 軸狀脂肪移植的實(shí)驗(yàn)和初步臨床研究. 中國(guó)修復(fù)重建外科雜志, 2012, 26(5): 576-582. doi: 復(fù)制

1. Goldwyn RM. Unproven treatment: whose benefit, whose responsibility? Plast Reconstr Surg, 1988, 81(6): 946-970.
2. Ersek RA. Transplantation of purified autologous fat: a 3-year follow up is disappointing. Plast Reconstr Surg, 1991, 87(2): 219-228.
3. Fagrell D, Eneström S, Berggren A, et al. Fat cylinder transplantation: an experimental comparative study of three different kinds of fat transplants. Plast Reconstr Surg, 1996, 98(1): 90-98.
4. Guyuron B, Majzoub RK. Facial augmentation with core fat graft: a preliminary report. Plast Reconstr Surg, 2007, 120(1): 295-302.
5. Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg, 2006, 118(3 Suppl): 108S-120S.
6. 趙坤, 梁杰, 彭智. 提高自體顆粒脂肪移植成活率的基礎(chǔ)研究及臨床進(jìn)展. 中國(guó)實(shí)用醫(yī)藥, 2010, 5(5): 238-240.
7. Rohrich RJ, Sorokin ES, Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg, 2004, 113(1): 391-397.
8. 楊楠. 取脂部位不同對(duì)自體脂肪顆粒注射移植療效影響的臨床研究. 中國(guó)美容醫(yī)學(xué), 2006, 15(7): 775-777.
9. Pu LL, Cui X, Fink BF, et al. The viability of fatty tissues within adipose aspirates after conventional liposuction: a comprehensive study. Ann Plast Surg, 2005, 54(3): 288-292.
10. Xie Y, Zheng D, Li Q, et al. The effect of centrifugation on viability of fat grafts: an evaluation with the glucose transport test. J Plast Reconstr Aesthet Surg, 2010, 63(3): 482-487.
11. Pu LL, Cui X, Fink BF, et al. Long-term preservation of adipose aspirates after conventional lipoplasty. Aesthetic Surg J, 2004, 24(6): 536-541.
12. 鄭丹寧, 雷華, 李青峰. 多種生長(zhǎng)因子及DMEM培養(yǎng)液對(duì)植入脂肪成活率影響的研究. 中國(guó)美容醫(yī)學(xué), 2005, 14(1): 34-36.
13. 杜學(xué)亮, 羅少軍, 郝新光, 等. 堿性成纖維細(xì)胞生長(zhǎng)因子在顆粒脂肪移植后血運(yùn)重建過(guò)程的作用. 中華整形外科雜志, 2005, 21(2): 128-131.
14. Pu LL, Coleman SR, Cui X, et al. Autologous fat grafts harvested and refined by the Coleman technique: a comparative study. Plast Reconstr Surg, 2008, 122(3): 932-937.
15. Thanik VD, Chang CC, Lerman OZ, et al. A murine model for studying diffusely injected human fat. Plast Reconstr Surg, 2009, 124(1): 74-81.
16. Meiser JD, Glasgold RA, Glasgold MJ, et al. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg, 2009, 11(1): 24-28.
17. Locke MB, de Chalain TM. Current practice in autologous fat transplantation: suggested clinical guidelines based on a review of recent literature. Ann Plast Surg, 2008, 60(1): 98-102.
18. Moore JH Jr, Kolaczynski JW, Morales LM, et al. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg, 1995, 19(4): 335-339.
19. Wolter TP, von Heimburg D, Stoffels I, et al. Cryopreservation of mature human adipocytes: in vitro measurement of viability. Ann Plast Surg, 2005, 55(4): 408-413.
  1. 1. Goldwyn RM. Unproven treatment: whose benefit, whose responsibility? Plast Reconstr Surg, 1988, 81(6): 946-970.
  2. 2. Ersek RA. Transplantation of purified autologous fat: a 3-year follow up is disappointing. Plast Reconstr Surg, 1991, 87(2): 219-228.
  3. 3. Fagrell D, Eneström S, Berggren A, et al. Fat cylinder transplantation: an experimental comparative study of three different kinds of fat transplants. Plast Reconstr Surg, 1996, 98(1): 90-98.
  4. 4. Guyuron B, Majzoub RK. Facial augmentation with core fat graft: a preliminary report. Plast Reconstr Surg, 2007, 120(1): 295-302.
  5. 5. Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg, 2006, 118(3 Suppl): 108S-120S.
  6. 6. 趙坤, 梁杰, 彭智. 提高自體顆粒脂肪移植成活率的基礎(chǔ)研究及臨床進(jìn)展. 中國(guó)實(shí)用醫(yī)藥, 2010, 5(5): 238-240.
  7. 7. Rohrich RJ, Sorokin ES, Brown SA. In search of improved fat transfer viability: a quantitative analysis of the role of centrifugation and harvest site. Plast Reconstr Surg, 2004, 113(1): 391-397.
  8. 8. 楊楠. 取脂部位不同對(duì)自體脂肪顆粒注射移植療效影響的臨床研究. 中國(guó)美容醫(yī)學(xué), 2006, 15(7): 775-777.
  9. 9. Pu LL, Cui X, Fink BF, et al. The viability of fatty tissues within adipose aspirates after conventional liposuction: a comprehensive study. Ann Plast Surg, 2005, 54(3): 288-292.
  10. 10. Xie Y, Zheng D, Li Q, et al. The effect of centrifugation on viability of fat grafts: an evaluation with the glucose transport test. J Plast Reconstr Aesthet Surg, 2010, 63(3): 482-487.
  11. 11. Pu LL, Cui X, Fink BF, et al. Long-term preservation of adipose aspirates after conventional lipoplasty. Aesthetic Surg J, 2004, 24(6): 536-541.
  12. 12. 鄭丹寧, 雷華, 李青峰. 多種生長(zhǎng)因子及DMEM培養(yǎng)液對(duì)植入脂肪成活率影響的研究. 中國(guó)美容醫(yī)學(xué), 2005, 14(1): 34-36.
  13. 13. 杜學(xué)亮, 羅少軍, 郝新光, 等. 堿性成纖維細(xì)胞生長(zhǎng)因子在顆粒脂肪移植后血運(yùn)重建過(guò)程的作用. 中華整形外科雜志, 2005, 21(2): 128-131.
  14. 14. Pu LL, Coleman SR, Cui X, et al. Autologous fat grafts harvested and refined by the Coleman technique: a comparative study. Plast Reconstr Surg, 2008, 122(3): 932-937.
  15. 15. Thanik VD, Chang CC, Lerman OZ, et al. A murine model for studying diffusely injected human fat. Plast Reconstr Surg, 2009, 124(1): 74-81.
  16. 16. Meiser JD, Glasgold RA, Glasgold MJ, et al. Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation. Arch Facial Plast Surg, 2009, 11(1): 24-28.
  17. 17. Locke MB, de Chalain TM. Current practice in autologous fat transplantation: suggested clinical guidelines based on a review of recent literature. Ann Plast Surg, 2008, 60(1): 98-102.
  18. 18. Moore JH Jr, Kolaczynski JW, Morales LM, et al. Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine. Aesthetic Plast Surg, 1995, 19(4): 335-339.
  19. 19. Wolter TP, von Heimburg D, Stoffels I, et al. Cryopreservation of mature human adipocytes: in vitro measurement of viability. Ann Plast Surg, 2005, 55(4): 408-413.