SVF-Gel辅助脂肪移植在面部年轻化美容中的应用

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1、分类号：R62学校代码：10392学科专业代码：100210学号：2151003152密级：硕士学位论文SVF-Gel辅助脂肪移植在面部年轻化美容中的应用SVF-GelassistedAutologousFatGraftinginFacialRejuvenation学位类型：医学硕士所在学院：第一临床医学院申请人姓名：杨姝丹学科、专业：外科学（整形）导师：王彪教授研究起止日期：2017年-2018年答辩委员会主席：郭树忠教授答辩日期：2018年05月18日二○一八年四月福建医科大学硕士学位论文目录英文缩略词„„„„„„„„„„„„„„„„„„„„„„(1)中文摘要„„„„„„„„„„„„

2、„„„„„„„„„„„(2)英文摘要„„„„„„„„„„„„„„„„„„„„„„„(4)前言„„„„„„„„„„„„„„„„„„„„„„„„„(6)临床资料„„„„„„„„„„„„„„„„„„„„„„„(7)结果„„„„„„„„„„„„„„„„„„„„„„„„(12)典型病例„„„„„„„„„„„„„„„„„„„„„„(13)讨论„„„„„„„„„„„„„„„„„„„„„„„„(20)结论„„„„„„„„„„„„„„„„„„„„„„„„(25)参考文献„„„„„„„„„„„„„„„„„„„„„„(26)综述„„„„„„„„„„„„„„„„„„„„„„„„(31)致谢„„„„„„„„„„„

3、„„„„„„„„„„„„„(45)福建医科大学硕士学位论文英文缩略词SVF-Gel（stromalvascularfractiongel）基质血管片段凝胶SVF（stromalvascularfraction）基质血管部分NS（normalsaline）生理盐水SL（syringeliposuction）注射器脂肪抽吸术PRP（platelet-richplasma）富含血小板血浆PRF（platelet-richfibrin）富含血小板纤维蛋白ANG（angiotensin）血管紧张素PBS（phosphatebuffersolution）磷酸盐缓冲液TGF(transformingg

4、rowthfactor)转化生长因子VEGF(vascularendothelialgrowthfactor)血管内皮生长因子IGF（insulin-likegrowthfactor）胰岛素样生长因子HGF（hepatocytegrowthfactor）肝细胞生长因子ASCs(adiposederivedstemcells)脂肪来源干细胞b-FGF（basicfibroblastgrowthfactor）碱性成纤维细胞生长因子CAL（cell-assistedlipotransfer）细胞辅助脂肪移植PDGF（plateletderivedgrowthfactor）血小板衍生因子1福建医

5、科大学硕士学位论文SVF-Gel辅助脂肪移植在面部年轻化美容中的应用中文摘要目的探讨血管基质片段凝胶（SVF-Gel）辅助脂肪移植在面部年轻化美容中的临床效果方法1、设计：根据受术者不同的面部轮廓，于其面部设计个性化脂肪移植范围并标记。2、麻醉：受区麻醉：于进针点进行浸润麻醉，使用加入0.1%肾上腺素的2%利多卡因，供区麻醉使用肿胀麻醉，供区肿胀麻醉进针点使用与受区进针点相同浸润麻醉。3、脂肪颗粒及SVF-Gel的制备：选取腿部或下腹部为脂肪颗粒供区，5-10min后使用20ml注射器连接抽脂针，形成手工负压，于皮下脂肪层反复多层次、多隧道呈扇面抽吸，抽取所需量脂肪混悬液后直立静置约10

6、分钟，可见脂肪分层，排除下层血性肿胀液，将静置后的脂肪组织分装于10ml无菌离心管中进行离心（1200g*3min），收集最上层油滴备用，去除最下层液体，获得中间层脂肪为Colemanfat即颗粒脂肪。取一半颗粒脂肪分装于两个10ml的注射器内，连接脂肪乳化器将脂肪充分乳化后进行第二次离心（2000g*3min），去除最上层油滴及最底层液体，可见中间层呈胶冻状混合物即SVF-Gel。将所制备的全部SVF-Gel与另一半的脂肪颗粒充分混均，以备注射移植使用。4、注射方法：面部进针点选择距受区边缘约1cm左右，进针点行局部麻醉后根据移植区选用不同直径的移植针自穿刺点进入受区，依据多点、多层次

7、、多隧道的注射移植技术，边退针边注射，总注射量可适当大于所需注射量，至受区稍膨隆或充盈饱满。注射时需注意尽量将脂肪均匀填充于整个受区的立体空间中，并与周围自然衔接。结果2017年1月至2018年3月，SVF-Gel辅助脂肪移植共48例，随访3-14个月，平均随访6个月。同时填充额颞部、眉间、眶周、面颊部、鼻背、鼻唇沟、颏部或同时2福建医科大学硕士学位论文填充其中三个或以上部位的患者28例；额颞部4例，面颊部5例，鼻唇沟4例；颏部3例