组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2016, Vol. 12 ›› Issue (5): 289-293.doi: 10.3969/j.issn.1673-0364.a451

• 论著 • 上一篇    下一篇

两种方法修复半侧颜面萎缩面部软组织缺损的临床对比研究

陈军宝，李秉航，滕利，卢建建，徐家杰，张超，解芳，杨莉亚，杨璐，李澍源，曹谊林   

  1. 北京协和医学院中国医学科学院整形外科医院
  • 发布日期:2020-07-23

The Clinical Comparison Study of Two Different Methods for Repairing Facial Soft Tissue Defect in Severe Progressive Facial Hem iatrophy

CHEN Junbao,LI Binghang,TENG Li,LU Jianjian,XV Jiajie,ZHANG Chao,XIE Fang,YANG Liya,YANG Lu,LI Shuyuan,CAO Yilin   

  1. Plastic Surgery Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College,Beijing 100144,China.Corresponding author:LU Jianjian E-mail:13910038881@163.com).
  • Published:2020-07-23
  • Contact: 公益性行业科研专项基金（201502016）；协和青年基金（33320140096）。

摘要： 目的 比较吻合血管的股前外侧筋膜脂肪瓣移植与自体脂肪移植两种方法,修复重度半侧颜面萎缩(PFHA)患者面部软组织缺损的临床效果。方法 自2013年09月至2015年12月,根据入组标准选取PFHA患者16例,分为自体脂肪移植组(A组,n=8)、吻合血管的股前外侧脂肪筋膜瓣移植组(B组,n=8)。所有入组患者用Mimics17.0、Geomagic studio 12.0图像处理软件进行面部对称性分析,计算面部组织缺损量,设计需重建的面部软组织范围,并进行手术治疗。入组患者于术后6个月来院复查,术后对两种不同方法修复面部软组织的临床各项指标进行统计。结果 两组患者术后面部对称性及软组织缺损均得到了明显改善(P0.05);临床指标比较结果:A组患者总手术时间、术后住院天数少于B组,B组住院次数少于A组,差异有统计学意义(P0.05);满意度评分结果:患者术后满意度A组优于B组(P0.05)。结论 应用自体脂肪移植修复重度PFHA患者面部软组织缺损的效果良好,完全可以达到传统的股前外侧筋膜脂肪瓣移植的修复效果,且患者满意度高,值得临床推广。

关键词: 三维数字化技术, 进行性半侧颜面萎缩, 自体脂肪移植, 股前外侧脂肪筋膜瓣移植

Abstract: Objective To evaluate clinical effect of free anterolateral thigh adipofascial flap transplantation and autologous fatgraft to repair facial soft tissue defection in severe progressive facial hemiatrophy.Methods From September 2013 to December 2015,16 patients with progressive facial hemiatrophy were selected according to enter criterion.The patientswere divided into two groups according to different surgicalmethods,autologous fat graftgroup(Group A,n=8)and free anterolateral thigh adipofascial flap group(Group B,n=8).The facial three-dimensional data were acquired via 3-D scanner preoperatively.Using Mimics 17.0 and Geomagic studio 12.0 software,facial 3-Dmodel of patientwas reconstructed, facial symmetry was analyzed,the volume of facial tissue defect was calculated and the reconstruction scope of facial soft tissue was designed.All the patients were operated and clinical indexeswere analysed after 6 months.Results The facial symmetry and soft tissue defect in Group A and Group B 6 months post-operation were both significantly improved compared with pre-operation(P＜0.05),while therewas no statistical significance between group A and group B(P＞0.05).The patients′clinical indexes:total operation time,postoperative hospital stay in Group B were greater than in Group A,times of hospitalization of Group B surpassed Group A with statistical significance(P＜0.05).Facial 3-D deviation analysis:there was no statistical significance between group A and group B(P＞0.05).Satisfaction score:patients postoperative satisfaction in Group A was better than in Group B(P＜0.05).The third person and surgeon satisfaction:no significant difference betweenthe two groups(P＞0.05).Conclusion The clinical effectof autologous fatgraft in repairing facial soft tissue defectof severe PFHA patients is non-inferior to free anterolateral thigh adipofascial flap transplantation with good clinical effects and high satisfactory,and isworthy of clinical application.

Key words: Three-dimensional digital technology, Progressive facial hemiatrophy, Autologous fat graft, Anterolateral thigh adipofascial flap transplantation

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