自体脂肪颗粒在隆乳术中的应用

发布时间：2018-05-26 12:32

本文选题：脂肪颗粒 + 自体脂肪　；参考：《华北理工大学》2015年硕士论文

【摘要】：目的1研究自体脂肪颗粒隆乳术术中提纯脂肪颗粒的不同方法(离心法和静置法)对术后脂肪移植成活率的影响;2采用同一方法(离心法)脂肪颗粒多次少量注射与大量单次注射对术后脂肪移植成活率的比较。3比较三种方法术后移植脂肪成活率在腺体层和肌层是否不同。方法实验分为A、B、C三组,A组7例13侧,B组8例14侧,C组6例12侧,每组手术方法相同,脂肪抽取方法相同,注射层次大体相同,A组和B组仅脂肪提纯方法不同,A组将抽取后的脂肪采用静止法提纯,B组采用低速离心法提纯;B组和C组提纯方法相同仅注射次数和注射量不同,B组采用单次大剂量注射提纯后的脂肪颗粒,C组分三次小剂量注射,每次注射时间间隔三个月。每位患者就诊后首先预测乳房所需填充脂肪量和供区脂肪厚度,术前常规检查后,术前当日留取影像资料方便术后效果对比,并B超测量乳房各层厚度(数值可精确至0.01cm),术后七天、术后一月、术后三月进行回访调查留取影像资料和B超测量数据,术后三个月后乳房形态基本不会再变化,计算出术后七天、术后一月、术后三月移植脂肪的成活率,每组数据比较各时间段移植脂肪的成活率,A组和B组成活率的比较可以反应哪种脂肪提纯方法脂肪成活率较高,B组和C组成活率的比较可以反应单次大量注射和少量多次注射的术后效果。结果A组静置法大量单次注射隆乳术术后测得:腺体层术后1个月平均厚度为0.38±0.06cm(成活率46.12±4.14%),术后3个月平均厚度为0.30±0.04cm(成活率41.13±2.99%);肌层层术后1个月平均厚度为0.30±0.04cm(成活率47.11±5.56%),术后3个月平均厚度为0.27±0.03cm(成活率43.52±5.18%);B组离心法大量单次注射隆乳术术后测得:腺体层术后1个月平均厚度为0.48±0.12cm(成活率53.09±2.13%),术后3个月平均厚度为0.44±0.14cm(成活率48.52±4.21%);肌层术后1个月平均厚度为0.41±0.11cm(成活率54.67±3.30%),术后3个月平均厚度为0.40±0.10cm(成活率52.82±2.80%)。C组离心法三次少量注射隆乳术病例测得数据:第一次术后三个月腺体层成活率为51.25±1.39%,肌层成活率为55.25±3.32%;第二次术后三个月腺体层成活率为50.76±2.16%,肌层成活率为54.95±3.12%;第三次术后三个月腺体层成活率为49.30±3.19%,肌层成活率为56.42±3.78%。将三次注射累计注射厚度和成活厚度来计算,腺体层成活率为50.39±1.36%,肌层成活率为55.54±2.59%。结论1提纯方法比较,低速离心法要比静置法术后成活率高;离心法比较,少量多次注射比单次大量注射成活率高。2腺体层和肌层成活率比较,静置法单次大量注射两个层次成活率没有明显差别,离心法少量多次和大量单次注射肌层成活率均高于腺体层。
[Abstract]:Objective 1 to study the effect of different methods (centrifugal method and static method) on the survival rate of fat transplantation during augmentation mammoplasty with autologous fat granules. Comparison of survival rate of fat transplantation between single injection and mass injection. 3 comparison of survival rate of fat graft in glandular layer and muscle layer by three methods. Methods the experiment was divided into three groups: group A, group B, group B: 8 cases, group B, group C, 6 cases, 12 sides. Each group had the same operation method and the same method of fat extraction. The level of injection is roughly the same as that of group A and group B only the methods of fat purification are different. Group A uses static method to purify the extracted fat. Group B is purified by low speed centrifugation. Group B and group C are purified with the same methods only the number of times of injection and the amount of injection are not the same. Group B was injected with three small doses of single large dose injection of fat granule C after purification. The time interval for each injection was three months. Each patient first predicted the amount of fat needed to fill the breast and the thickness of the donor fat. After routine preoperative examination, the images were taken on the same day to facilitate the comparison of postoperative results. The thickness of each layer of breast was measured by B-ultrasound (the value can be accurate to 0.01 cm ~ (-1). Seven days after operation, one month after operation, and three months after operation, the imaging data and the data measured by B-mode ultrasound were collected. After three months of operation, the shape of the breast was basically no longer changed. Calculate the survival rate of fat grafts seven days, one month and three months after operation, The comparison of survival rate of group A and group B can reflect which method of fat purification is higher. The comparison of survival rate of group B and group C can reflect the single mass injection and the comparison of survival rate of group C and group B can reflect the survival rate of fat grafts in each time period. The postoperative effect of a small amount of multiple injections. Results in group A, the average thickness of glandular layer was 0.38 卤0.06 cm (survival rate 46.12 卤4.14 cm) and 0.30 卤0.04 cm (survival rate 41.13 卤2.99 cm) 1 month after operation and 0.30 卤0.04 cm (survival rate 41.13 卤2.99 cm) in group A. The average thickness was 0.27 卤0.03 cm (survival rate 43.52 卤5.18) in group B: the mean thickness of glandular layer was 0.48 卤0.12 cm (survival rate 53.09 卤2.13 cm) 1 month after operation, and the mean thickness of muscle layer was 0.44 卤0.14 cm (survival rate 48.52 卤4.21 cm) in 3 months after operation. The mean thickness was 0.41 卤0.11 cm (survival rate 54.67 卤3.30 cm) and 0.40 卤0.10 cm (survival rate 52.82 卤2.80 cm) in group C: the survival rate of glandular layer was 51.25 卤1.39 in the first three months after operation, and the survival rate of muscular layer was 51.25 卤1.39 in the first three months after operation. The survival rate of glandular layer was 55.25 卤3.322.The survival rate of glandular layer and muscular layer was 50.76 卤2.16and 54.95 卤3.12respectively, and the survival rate of glandular layer was 49.30 卤3.19 and the survival rate of muscular layer was 56.42 卤3.78 three months after the third operation. The survival rate of glandular layer and muscle layer was 50.39 卤1.36 and 55.54 卤2.59 respectively. Conclusion (1) the survival rate of low speed centrifugation is higher than that of static spell, and the survival rate of small amount of multiple injection is higher than that of single mass injection of 2. 2% higher than that of muscle layer. There was no significant difference in survival rate between the two levels of single mass injection by static method. The survival rate of myometrium injected by centrifugal method was higher than that of glandular layer.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R622

【参考文献】