体外超声吸脂术200例临床效果观察

目的：探讨体外超声吸脂术治疗局部及全身性肥胖的疗效以及安全性。方法：共收治患者200例，按照其要求，分别对腰腹部、大小腿、上臂、臀部进行了体外超声吸脂，记录腰腹部位吸脂注入的麻药量、吸出液量以及纯脂肪量，并以一个月为限记录各部位体围的变化。结果：腰腹部人均吸出脂肪量2505．91ml，单次最高吸出量9600ml，体围缩小4cm-14cm，其余部位体围均有明显改变，统计学处理术前术后差异有显著性意义，无任何反弹迹象，术中术后患者出血量较少，痛苦及不舒适程度较轻，术后恢复迅速，皮肤平坦，无反弹现象及严重并发症发生。结论：体外超声吸脂减肥术安全可靠，效果确切、彻底，患者易接受。     

局部大量体外超声吸脂的安全性评价及体会

目的:探讨行局部体外超声大量吸脂的安全性。方法:对400例肥胖患者464个部位行体外超声吸脂术,记录局部吸出脂肪量、注入肿胀液量,注入利多卡因浓度,观察术中术后患者生命体征及利多卡因毒性反应,并发症出现情况。结果:其中吸出脂肪量超过4000ml共124个部位(腰腹部76例,大腿48例),局部大量体外超声吸脂术中、术后患者生命体征均平稳,术后无一例出现休克、严重利多卡因中毒症状,术后恢复正常,无感染、皮肤坏死、不平坦及松弛等其它并发症发生。结论:局部肿胀麻醉下行大量体外超声吸脂是安全、可靠的。     

持续硬膜外麻醉下行大量体外超声吸脂术的体会

目的：评价持续硬膜外麻醉下行大量体外超声吸脂的疗效及安全性,并总结经验。方法：对15例肥胖患者在持续硬膜外麻醉下行体外超声吸脂术（其中腰腹部6例,大腿部9例）,记录注入肿胀液量、吸出纯脂肪量,术前术中术后患者生命体征、血液成分变化,并观察并发症出现情况。结果：吸出脂肪量3300～4800ml,平均4100ml;11例短期内均出现血压下降、脉搏加快,皮肤、粘膜苍白,心悸,全身乏力,恶心、呕吐,纳差,眩晕等血容量不足的表现,查见红细胞、血红蛋白明显降低;术后恢复时间较局部肿胀麻醉者长,平均5天（以术后患者可自行下地行走,无明显不适为限）,局部瘀紫严重,无感染、皮肤坏死、不平坦及松弛等其它并发症发生。结论：持续硬膜外麻醉下行大量体外超声吸脂需慎重,并要切实做好术前准备及术后处理。     

下肢体外超声吸脂的疗效及操作技巧

目的　探讨体外超声吸脂术治疗下肢大小腿脂肪堆积的疗效、安全性 ,以及对操作技巧进行总结。方法　接受吸脂者共 81例 ,根据其要求 ,分别对大腿部 (6 0例 )以及小腿部 (2 1例 )进行体外超声吸脂术 ,记录所注入的麻醉药量和吸出的纯脂肪量 ,以及吸前和吸后 1～ 3个月的腿围变化。结果　大腿部人均吸出脂肪量 36 73ml,最高吸出量 6 10 0ml;大腿正中围缩小 (4.6 5± 1.10 )cm ,最大缩小 12 .5cm。小腿人均吸出脂肪量 6 5 0ml,最高吸出量 12 0 0ml;小腿正中围缩小 (3± 1.0 2 )cm ,最大缩小 9cm。吸脂疼痛程度较轻、出血量少、吸后皮肤平坦、无严重并发症发生、无反弹迹象。在操作过程中 ,熟知腿部脂肪分布特点 ,注射麻醉药量充分、均匀 ,超声时间适度 ,吸刮层次准确是手术成功的根本保障。结论　体外超声吸脂用于腿部脂肪堆积的治疗 ,是一种安全、可靠、有效的方法 ,医师的熟练操作技巧是手术成功至关重要的因素。     

腰腹部体外超声吸脂术的应用及疗效探讨

目的：探讨体外超声吸脂术Ⅰ期治疗腰腹多部位脂肪堆积的效果及其安全性。方法：在肿胀麻醉技术基础上，通过特定频率的超声波在体外乳化脂肪，再应用负压将乳化的脂肪抽出体外，共完成腰腹部脂肪堆积治疗l000例。结果：1000例患者平均吸出脂肪量2900ml，最大量9600ml，除了l0例血清肿及4例局限表浅皮肤坏死以外，无其他严重并发症。全身肥胖明显者获得良好减肥效果，局部脂肪堆积者取得良好的塑形效果，吸脂后术区皮肤均有不同程度的回缩，无反弹。结论：体外超声腰腹部脂肪抽吸术安全可靠，整体塑形效果良好。     

外超声吸脂在小腿塑形中的应用

目的：探讨体外超声吸脂术治疗小腿脂肪堆积的疗效及安全性。方法：对16例小腿脂肪堆积求术者行体外超声吸脂术，记录术前、术后26个月的腿围变化。结果：小腿人均吸出脂肪量250～650ml，小腿周径减少1．2～2．5cm，吸脂出血量少，脂血比增大，吸后皮肤平坦，无严重并发症。结论：外超声用于小腿吸脂，是一种安全、有效的方法。     

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。     

肿胀麻醉下外超声与非超声吸脂术的比较研究

目的：比较肿胀麻醉法下的外超声吸脂与单纯负压吸脂术的差别，以探讨外超声吸脂术的优点，方法：将10－例吸脂者的腹部均分为左右两侧，在肿胀麻醉下一侧行外超声吸脂，另一侧行单纯负压吸脂，比较吸脂效果并分析吸出物，结果：临床吸脂患者中，外超声作用侧所吸出的上层脂肪占总吸出量的百分比大于非超声吸脂侧（P＜0．001），吸出物中外超声吸脂侧血红蛋白浓度低于非超声吸脂侧（P＜0．001），三酰甘油浓度高于非超声吸脂侧（P＜0．001），血红蛋白与三酰甘油的比值低于非超声侧（P＜0．001），提示外超声吸脂明显较非超声吸脂术脂肪乳化好，出血亦少，且操作省力，术后并发症轻，皮肤收缩效果好，结论：外超声吸脂术是一种去除局部堆积脂肪的更为安全，有效的方法。     

体外超声辅助下的脂肪抽吸术

目的介绍体外超声辅助下的脂肪抽吸技术的操作要点及206例患者的临床体会.方法运用肿胀麻醉技术进行术区浸润后,应用体外超声设备对术区进行体外超声处理,能量设置为3 W;作用时间为10～15*!min.然后,运用传统的脂肪抽吸方法进行吸脂塑形.结果 206例患者,脂肪抽吸量为200～4*!300*!ml,其中有1例患者发生局部小面积皮肤浅层坏死,3例发生血清肿,经换药1～2周后痊愈,其余患者无严重的并发症发生.206例患者均获得较明显的吸脂塑形效果,吸脂后术区皮肤均有一定程度的回缩.结论体外超声波辅助下的脂肪抽吸术安全可靠、易于掌握,其对脂肪的乳化作用有利于脂肪的吸出,同时有利于皮肤的回缩.     

体外超声辅助下的脂肪抽吸术

目的 介绍体外超声辅助下的脂肪抽吸技术的操作要点及206例患者的临床体会。方法 运用肿胀麻醉技术进行术区浸润后，应用体外超声设备对术区进行体外超声处理，能量设置为3W；作用时间为10～15min。然后，运用传统的脂肪抽吸方法进行吸脂塑形。结果 206例患者，脂肪抽吸量为200～4300ml,其中有1例患者发生局部小面积皮肤浅层坏死，3例发生血清肿，经换药1～2周后痊愈，其余患者无严重的并发症发生。206例患者均获得较明显的吸脂塑形效果，吸脂后术区皮肤均有一定程度的回缩。结论 体外超声波辅助下的脂肪抽吸术安全可靠、易于掌握。其对脂肪的乳化作用有利于脂肪的吸出，同时有利于皮肤的回缩。     

External Ultrasound-Assisted Lipoplasty from Our Own Experience

External ultrasound-assisted liposuction (XUAL) is a new technique that requires traditional aspirative liposuction after the application of high frequency ultrasonic fields delivered through the skin into a wetted tissue. Initial data suggest that it has some advantages over the traditional procedure, especially regarding the achievement of less traumatic surgery with superior clinical outcome. This preliminary report describes a comparative study between conventional liposuction and the external ultrasound-assisted technique as the modality of treatment for fat deposits in 65 bilateral anatomical areas. The results showed considerable superiority of the ultrasound-assisted series. We found less resistance to the canulla with more rapid removal of fat and the aspirated tissue showed less blood content with intact viable fat cells. Patients report less pain and discomfort on the ultrasound-treated sides and we found less swelling and bruising, with superior skin shrinkage. Clinical recovery was also enhanced by the external ultrasound and no complications were reported with the technique.     

眶隔固定及眼轮匝肌悬吊眼袋整形术女性臀部肥胖分型与臀部脂肪吸脂塑形术

目的　探讨中国女性臀部分型与臀区塑形吸脂术中分区的应用。方法　1996年至今,按臀部肥胖分型理论,用改进的肿胀麻醉配方,与负压抽脂塑形方法,治疗女性臀部、股部各类型肥胖46例。结果　经6～36个月随访,均达到理想的体型雕塑曲线美的吸脂效果。结论　采用臀区分型理论用于指导臀部与股部肥胖的吸脂雕塑人体曲线及采用改进的肿胀负压吸脂术有理想的治疗效果,值得推广。     

Ultrasound-assisted liposuction as a treatment of fat necrosis after deep inferior epigastric perforator flap breast reconstruction: a case report

A single case is reported utilizing ultrasound-assisted liposuction (UAL) to treat fat necrosis after deep inferior epigastric artery perforator flap breast reconstruction. UAL treatment resulted in softening of the fibrous fat necrotic areas, while maintaining acceptable breast contour. UAL is safer and less invasive than traditional treatments for fat necrosis including direct excision and suction-assisted liposuction.     

Lower body subcutaneous fat accumulation and diabetes mellitus risk.

BACKGROUND: Type II diabetes mellitus (DM) is associated with obesity. However, body fat distribution plays an important role in this disease's pathogenesis. The prevailing hypothesis is that a more central distribution of adipose tissue relative to peripheral locations is associated with DM. I hypothesized that preferential accumulation of subcutaneous adipose tissue in the lower body is associated with a lesser likelihood of insulin resistance (IR) and DM than when fat accumulates in a central distribution. This is independent of the body mass index (BMI) or waist circumference. METHODS: Upper and lower body circumferences and skinfold thickness were related to IR and DM in 7634 adults in the Third National Health and Nutrition Survey population that underwent oral glucose tolerance testing after an overnight fast. Logistic regression and contour analyses were used to determine the effect circumference and skinfold thickness measurements had on the presence of IR or DM. The various measurements were then stratified into BMI categories to refine the contribution each factor made to these diseases further. RESULTS: Truncal subcutaneous fat correlated positively with IR and DM after correction for age and BMI. The thigh circumference and skinfold thickness correlated negatively. Regression and graphic analysis of the BMI-thigh skinfold thickness-IR relationship demonstrated that the greatest degree of IR occurred in the obese who had relatively small lower body adipose tissue depots. Those with large accumulations of lower body subcutaneous fat were less likely to have IR or DM. CONCLUSION: The results of this study have shown that the accumulation of fat in lower body subcutaneous adipose tissue depots is associated with a lower likelihood of IR and DM than when it deposits in centrally located sites. Lower body peripheral fat may serve to buffer the effect of excess ingested energy, and central body fat may be involved in the pathogenesis of IR and DM. This effect was independent of overall adiposity in men and women and independent of waist circumference in men.     

中原地区青年女性臀部和大腿形态测量及临床意义

目的通过对中原地区青年女性臀部及大腿形态学测量及分析,为临床相关手术提供美学参考。方法测量551名未婚健康女性腰围、臀围、大腿最大围、大腿长及大腿长身高比,并根据不同身高组、体重组对相关数据进行统计分析。结果测量数据显示腰围、臀围、大腿最大围、大腿长及大腿长身高比分别为（70．74±5．86）、（87．16±4．19）、（51．87±3．27）、（42．35±2．38）cm及（26．1±1．23）％。臀围及大腿最大围在不同身高、体重组之间差异有统计学意义,且与身高、体重、腰围均存在正相关;大腿长、大腿长身高比在不同身高组之间差异有统计学意义,且与身高呈正相关。结论中原地区青年女性有关臀部及大腿形态学测量数据可为相关整形手术方案的制定及修复效果的评价提供依据,特别是对脂肪抽吸术具有一定的I临床参考价值。     

Soft tissue composition in upper leg lipodystrophy: application of dual energy x-ray absorptiometry

Liposuction is a safe procedure for removal of subcutaneous fat in patients with upper leg lipodystrophy. We present a young woman with lipodystrophy of upper leg who underwent ultrasound-assisted three-dimensional suction lipectomy. The aim of the study was to determine the amount of fat to be removed before liposuction and to evaluate soft tissue composition before and after liposuction. At the initial meeting and four months later, body composition parameters were examined by dual X-ray absorptiometry (DXA), which produced a precise assessment of regional fat distribution. The baseline DXA measurements revealed excess of fat tissue for the lateral regions of the right and left legs, and for the area from the waist to hip. After liposuction of established amount of tissue, the same measurements revealed a decrease of fat tissue in all three regions, whereas no significant differences were observed for lean mass. We concluded that the suction lipectomy produced decrease in the fat mass of legs without musculature damage. The DXA technique can be useful in predicting fat removal before suction lipectomy and in estimating changes in soft tissue composition after surgical treatment.     

Sicherheits- und Machbarkeitsstudie einer neuen radiofrequenzassistierten Fettabsaugungstechnik

The present study analysed the feasibility, safety and effectiveness of a new technique of radiofrequency-assisted liposuction in a variety of body areas. Between July 2008 and June 2009 51 patients underwent treatment with the Body-Tite? system. The average patient age was 38.8+/?12.4% (87% women, 13% men). Aesthetic results as well as local and systemic complications immediately, at 6 and at 12 weeks postsurgery were assessed. The majority of patients (40) underwent bilateral treatment in the hip and lower abdominal areas. Roll formation on the side of the thorax and flanks was treated in six patients, male“love handles” in five, inner upper thigh and knee in four, buttocks in three, upper arms in two and male breasts in one patient. The technique was successfully performed in all cases. The volume of aspirated fat per patient was 2404+/?1290 ml with an operating time of 180+/?44 minutes. Marked improvement in body contour and skin firmness was observed postoperatively in all patients. No systemic or local complications were observed and the postoperative period was relatively pain-free (a score of 2 on the visual analog scale). Weight and girth reduction were verified at 3-month follow-up. The study confirms that radiofrequency-assisted liposuction can safely and effectively remove large volumes of fat while tightening connective tissue or loose or fibrosed areas – with little“down time”. Compared with other methods, none was able to achieve the same quality of liposuction or tightening as that seen with the new radiofrequency Body-Tite? system.