超声吸脂术初探

对５１例患者的超声吸脂治疗取得了较好的美学效果。应用不同超声波强度对病人进行分组治疗的结果表明：体内超声碎脂速度不仅与超声波强度有关，还受其它因素影响。并发症出现率随超声波功率的增加有增加的趋势。还就一些影响超声去脂效果的因素进行了初步分析。     

内超声吸脂术体会

我科自2002年11月至2006年3月间,应用体内超声吸脂技术进行吸脂塑形110例,取得良好效果,现报道如下。1临床资料1.1一般资料:本组110例中,女105例,男5例。年龄19￣47岁,平均28岁。腰部80例,双大腿10例,臀部8例,上臀4例,背部3例,胸及乳房2例,小腿2例,面额及下颏1例。1.2病例选择:     

体外超声吸脂术的应用进展

体外超声吸脂术（exltemalul trasound—assisted liposuction，EUAL）是近年来引入我国的一种较新的吸脂方法．此方法不仅克服了普通负压吸脂术出血量大、疼痛明显、并发症较多等不足，而且又避免了体内超声吸脂术（ultrasound assisted liposuction，UAL）所导致的乳化过度、脂肪液化、皮肤灼伤等，其疗效、安全性及可操作性经过大量临床实践已受到国内、外整形美容外科学界的充分肯定。自1997年EUAL问世至今，国内外学者对体外超声吸脂术进行了大量的临床观察，现分别针对EUAL的作用原理、具体手术操作、术后处理、并发症、临床疗效、护理体会、应用前景以及存在的问题等进行如下综述。     

外超声吸脂术

抽脂术是目前最常见的美容外科手术 ,与传统手术方法相比 ,具有微创性及复发率低的优点 ,但在那些纤维隔多、皮肤松弛的部位效果不甚明显。内超声吸脂术能有效地去除这些部位的脂肪 ,但存在侵入性损伤及皮肤烧伤等问题[1 ] 。1 996年 ,Ｓｉｌｂｅｒｇ发明了外超声吸脂术 ,将高频、高能的超声通过皮肤作用于皮下脂肪 ,既保证了超声的作用效果又减少了侵入性损伤[1 ] 。然而 ,目前关于外超声作用机制及效果的观点尚不一致。现综述如下 ,以供参鉴。一、超声的物理性质超声是指频率高于人耳听力范围 (1 6 0 0 0～ 2 0 0 0 0Ｈｚ)的高频声波[2 ,3…     

肿胀技术下负压吸脂与超声吸脂术的比较

为比较肿胀技术下负压吸脂术与超声吸脂术的优缺点 ,1 996年 1月～ 1 998年 1月我们各以 35例进行对比观察 ,现报告如下。1　材料与方法两组均为女性 ,在年龄、肥胖类型、吸脂部位等差异均无显著性意义。术前触摸 5cm宽的皮肤皮下脂肪厚度、腹部围度测定等差异也无显著性意义 ( P>0 .0 5,表 1～ 3)。肿胀液配方及注射方法见文献 [1 ],用量为每例1 50 0～ 1 0 0 0 0 ml,平均 60 0 0 ml。超量灌注的标准 :吸脂部位明显肿胀、坚韧、皮肤变白、呈轻度桔皮样外观。利多卡因用量 :( 36.2± 1 1 .7) mg/kg体重 ,最大量 63.6mg/kg体重。两组间应用…     

体外超声吸脂术204例报告

目的 探讨体外超声吸脂术的疗效、安全性、操作技能及总结该术式的优缺点。方法 在门诊手术室应用美国的SILBERG E．U．A．^TM体外超声乳化系统和HEROULES^TN大力神吸脂设备，以肿胀麻醉为主，少数以亚麻醉加肿胀麻醉，共行吸脂术204例。结果 满意率90．69％。最大吸脂量6800ml，最小吸脂量250ml，平均每例吸脂量1908ml，平均每部位吸脂量为1006ml，吸脂量超过传统吸脂方法。优点为脂肪吸出量大，效果明显，出血少，疼痛轻，安全。缺点为吸出的脂肪已被坏，不能再利用。对术后不满意情况如表面凸凹不平、积液、双侧不均匀、吸脂量不足、疼痛、吸脂口愈合减慢、皮下瘀斑，提出相应的处理方法。大多数患者存在不同程度硬结，提醒大家注意术中患者血压下降情况。结论 该吸脂方法简便、安全、可靠，是理想的去脂方法之一。并提出多次少部位吸脂，术后对患者生活、工作影响较小，患者术后反应较佳，社会效益好。     

超声吸脂术临床应用分析

报告超声吸脂术189例，均取得满意治疗效果。本阐述了超声吸脂术的原理．对其技术要点和优点进行了总结，对超声吸脂术常见并发症的防治和该技术尚存在的问题进行了探讨。     

超声吸脂术38例体会

我科采用中国科学院研制的新一代超声去脂减肥仪进行超声吸脂术 38例 ,其中青年女性 33例 ,中老年女性 5例 ,均达到满意的治疗效果 (图 1)。体会如下。术前　　　　　　　　　术后图 1　超声吸脂治疗效果一、心理治疗求美者大多数对手术要求较强烈 ,且期望值较高 ,还要求住院时间尽量短 ,不影响工作 ;然而 ,同时伴有恐惧心理者亦很多。因此 ,术前应尽量多了解求美者心理及对手术的要求 ,向受术者介绍手术过程及术后的注意事项 ,使其增强对医生的信任感 ,并引导其结合自身条件来客观的评价手术效果。二、围手术期处理术前应进行血常规、心电…     

Quantitative Analysis of Liposuction with B Mode Ultrasound

Background The objective of this study was to determine whether ultrasonography is a reliable method for monitoring subcutaneous fat thickness in the quantitative analysis of liposuction results.Methods Subcutaneous fat thicknesses before and 2 months after liposuction in prespecified areas were measured in 14 patients using a 7.5-MHz ultrasound scanner. Pre- and postoperative subcutaneous fat thicknesses were compared statistically.Results The thicknesses of pre- and postoperative subcutaneous fat layers were statistically different.Conclusion Ultrasound is a valuable tool for perioperative guidance, preoperative planning, and quantitative analysis of the procedure results.     

Liposuction sepsis �C be alert

Postoperative infection in liposuction patients may be exceedingly difficult to clinically appreciate because of the skin edema, colour changes and even blistering that can occur. The authors outline such a case with practical advice about establishing an accurate and precise diagnosis of an early septic process.     

Cutis marmorata Resemblance After Liposuction

Liposuction is a safe method for the treatment of lipodystrophy. It gives good results in relation to body contours, especially when the superficial and deep layers of the superficial fascia are aspirated. The authors present clinical cases of female patients who underwent liposuction of the abdomen, flanks, and back in which superficial and deep liposuction was used. In the immediate postoperative period, these patients presented a skin pattern of marbled appearance, involving rosy-purplish stains intermingled with other whitish stains on the skin in the areas subjected to surgery and resembling the cutis marmorata described in the literature. Even 1 year after the operation, the stains had not receded. The literature mentions cases of cutaneous necrosis provoked by a temperature increase induced by liposuction cannulas. This trauma said to be the determining factor for local lesions of the subdermal plexus. However, no cases involving lesions of this plexus attributable to mechanical trauma from cannulas are cited. According to several authors, it is important during superficial liposuction to maintain a strip about 1 cm thick under the deep dermis for the preservation of the arterial plexus of the skin. This would avoid the formation of a skin pattern resembling cutis marmorata.     

Liposuction Breast Reduction

All breast reductions since 1996 have been performed with only liposuction. Removal of up to 2250 ml per breast has been obtained in 45 patients, without any complications. Significant skin retraction results from a very superficial subcutaneous liposuction, with a significant volume reduction of the gland. One bilateral mastopexy was performed subsequently.     

Scientific Basis for the Use of Hypotonic Solutions with Ultrasonic Liposuction

Background A number of plastic surgeons have advocated using hypotonic solution in ultrasound lipoplasty, theorizing that induced adipocyte swelling increases membrane susceptibility to ultrasonic disruption. Additionally, it has been theorized that potassium increases membrane permeability. This study aimed to determine the effect of solution osmolality on adipocyte diameter, the time course of hypotonic solution action, and the effect of potassium addition on adipocyte diameter. Methods Base solutions with three different osmolalities were prepared: normal saline (NS) (154 mOsm/l), 1/2NS (77 mOsm/l), and 1/4NS (38.5 mOsm/l). Each solution was modified to contain 0, 5, and 10 mEq/l of potassium and adjusted to starting osmolality. Adipocytes of six patients were suspended in the nine solutions, and diameters were determined at 0, 15, 30, and 45 min. Diameters were measured using imaging software (Kodak ID 3.6). Results At time 0, the average adipocyte diameter was 79 ± 8 μm, and no difference was seen in any of the solutions. Cells in the NS group showed no significant increase in diameter over 45 min. The 1/2NS group achieved an 8% ± 1.9% increase in diameter at 45 min (p < 0.05). The 1/4NS group showed an increase by 14% ± 2.4% (p < 0.01) at 15 min, and 15% ± 2.3% (p < 0.01) at 45 min. Potassium had no independent effect on cell diameter. Conclusions Hypotonic solution can significantly increase human adipocyte diameter. The findings showed that 1/2NS had a significant effect within 15 min. Tumescent solutions with an osmolality of 1/4NS may be useful in facilitating ultrasonic lipoplasty.     

闭式引流在脂肪抽吸术后应用的可行性及临床意义

目的探讨闭式引流在脂肪抽吸术后应用的可行性及临床意义。方法 2005年4月～2010年12月,对78例腰腹环周脂肪抽吸术,随意选取39例术后在放置引流管的切口外采用贴覆消毒后的尿路造口袋引流并记录引流量,引流袋在术后24～120 h（引流量〈10 ml）揭除,观察切口周围皮肤并常规处理切口。其余仍采取开放引流为对照,对伤口闭合前换药次数及切口愈合情况进行对比分析。2组剑脐中点水平、经脐水平、脐耻中点水平周径差异无显著性。结果 2组手术时间、肿胀液注入量及吸出纯脂肪量差异无显著性。与开放引流组相比,闭式引流组术后换药次数少[（1.1±0.3）次vs.（3.7±1.0）次,t=-32.922,P=0.000],切口愈合延迟少[4例vs.22例,χ2=18.692,P=0.000]。闭式引流组经过24～120 h术后观察经切口流入引流袋的渗出液（150～1600 ml）引流通畅;贴合处皮肤无过敏、瘙痒。结论闭式引流简单安全有效。它可准确观察记录术区渗液情况,避免术后术区污染,免除术后频繁换药,减少切口愈合延迟,提高患者的术后舒适度。     

Liposuction: Optimizing factors

Two aspects of liposuction procedures are discussed as ways of improving results. First, to help with the efficiency of fat removal several technical points are considered, especially the freedom and the facility of performing the liposuction procedure with a syringe without the aid of an aspirator. Surgeons are showing a growing interest with this new method. New and practical material that allows a reduced number of necessary manipulations is described. Second, we stress the importance of drainage, especially in relation to the resumption of activity which is much quicker due to the absence of postoperative bruising. When using drainage, the final result can be obtained as early as the second or third day.     

Liposuction: More curettage than aspiration

After infiltration with epinephrine solution in each adipose area, an 8- or 10-mm cannula, without the suction tube connected, was introduced. With a curettage maneuver and by directing the cannula upward, the fat began to come out spontaneously. After obtaining a considerable amount of fat, the suction tube was connected and the remaining fat tissue aspirated at low suction power (250 mm Hg). With this curettage maneuver adiposity of the abdomen, knees, and trochanteric areas can be reduced. However, in the back, buttocks, or thighs, where adiposity is more fibrous, aspiration is needed from the start in almost every case, but always at low-power suction. This procedure is indicated in particular for the face and neck and for secondary liposuction. The fact that fat comes out easily through the cannula (without suction) demonstrates that the curettage maneuver is more important than the aspiration. Only with curettage can a considerable amount of fat be removed. No fat is removed when aspiration of 1 atm without a curettage maneuver is used. Suction only helps to remove fat already mobilized and free in the cannula. Our experience includes 34 patients.     

年轻女性脂肪抽吸术的特点分析

目的 探讨年轻女性脂肪抽吸术的特点.方法 对28例21～30岁的女性进行肿胀法负压吸脂,并进行心理调查.结果 经6个月～1年的随访,所有患者自我感觉及客观评价均满意,达到了理想的体形重塑目的,再现了女性身材的曲线美.结论 心理健康的年轻女性吸脂效果术后可获得理想的女性人体曲线.