自体脂肪结合富血小板血浆注射应用于面部年轻化中的效果分析

王凤兰 刘雷

[摘要]目的：探究自体脂肪结合富血小板血浆（Platelet-rich plasma，PRP）注射在面部年轻化中的应用效果。方法：选取2017年1月-2018年10月在笔者医院进行面部年轻化治疗的92例就医者，根据手术方法分为自体脂肪组（46例）和联合组（46例）。所有患者均给予自体脂肪颗粒进行治疗，联合组患者则加用PRP注射进行治疗。观测并比较两组就医者的面部VISIA皮肤检测结果、皮肤老化程度、鼻唇沟皱纹严重程度分级（Wrinkle severity rating scale，WSRS）、滿意度及术后3个月脂肪存活率。结果：治疗后，联合组与自体脂肪组纹理比较差异无统计学意义（P>0.05），但联合组的皱纹、斑点和毛孔改善程度上显著优于自体脂肪组，差异具有统计学意义（P<0.05）。术后3个月，两组就医者的皮肤老化程度以及鼻唇沟WSRS评分均显著下降，且联合组的皮肤老化程度以及鼻唇沟WSRS评分显著低于自体脂肪组，差异具有统计学意义（P<0.05）。术后3个月，联合组就医者和医师满意度及脂肪存活率均高于自体脂肪组，差异具有统计学意义（P<0.05）。结论：自体脂肪结合PRP注射在面部年轻化治疗中效果显著，可显著改善就医者的皮肤老化症状，提高术后满意度以及脂肪存活率，值得临床推广与应用。

[关键词]自体脂肪移植;富血小板血浆;面部年轻化;皮肤老化程度;皱纹严重程度分级;满意度

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）05-0086-04

Abstract： Objective  To explore the effect of autologous fat combined with platelet-rich plasma （PRP） injection on facial rejuvenation. Methods  92 patients who underwent facial rejuvenation therapy in our hospital from January 2017 to October 2018 were randomly divided into the autologous fat group （46 cases） and the combined group （46 cases）. All patients were treated with autologous fat granules， while the combined group was added with PRP. The facial VISIA skin test results， skin aging degree， nasolabial fold wrinkle severity classification （WSRS）， satisfaction degree and 3 months fat survival rate were observed and compared between the two groups. Results  After treatment， there was no significant difference in texture between the combined group and the autogenous fat group （P>0.05）. But the improvements of wrinkles， spots and pore in the combined group were significantly better than those in the autologous fat group （P<0.05）. Three months after operation， the skin aging degree and score of nasolabial groove WSRS in the two groups significantly decreased， and the skin aging degree and score of nasolabial groove WSRS in the combined group were significantly lower than those in the autologous fat group （P<0.05）. At 3 months after operation， patients and doctors's atisfaction and fat survival rate in the combined group were higher than those in the autologous fat group （P<0.05）. Conclusion  The effect of autologous fat combined with PRP injection in facial rejuvenation treatment is remarkable. It can significantly improve the symptoms of skin aging， improve the satisfaction after operation and fat survival rate， which is worthy of clinical application.

Key words： autologous fat transplantation; platelet-rich plasma（PRP）; facial rejuvenation; skin aging; wrinkle severity rating scale（WSRS）; satisfaction

人的脸部外形随着年龄的增长会逐渐出现面容老化问题，包括凹陷、萎缩消瘦、皱纹等情况，严重影响了外貌美观。随着人们生活水平以及物质需求水平的提高，面部美观要求也越来越高，面部美容手术应运而生。通过自体游离脂肪或各种人工材料进行皮下软组织充填手术，使皮肤看起来更加饱满、年轻化。其中填充物包括外源性填充物和内源性填充物，而前者由于具有组织相容性差等缺点，使得应用内源性填充物进行手术注射越来越受到就医者的青睐，在医疗技术水平不断提高的情况下，手术的成功率以及手术效果也越來越好[1-2]。代天均等[3]研究发现，自体颗粒脂肪移植可明显改善皮肤老化情况。而有……