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。     

振动脂肪抽吸技术962例报道

目的：介绍振动脂肪抽吸技术的操作要点以及962例脂肪抽吸术的临床应用体会。方法：利用肿胀麻醉技术进行手术部位浸润后，应用振动吸脂仪器进行脂肪抽吸和身体塑形。结果：962例就医者脂肪抽吸量为100～4500ml，其中4例就医者发生皮下血清肿，经局部穿刺排液，加压包扎后吸收；3例发生切口延迟愈合；无1例发生局部皮肤坏死。全部就医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：与传统的吸脂术相比，振动脂肪抽吸术安全可靠，易于掌握，尤其适用于大范围脂肪抽吸。     

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 2 0 6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　 2 0 6例患者 ,脂肪抽吸量为 2 0 0～ 4 30 0ml,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。 2 0 6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     

门诊局麻下抽脂89例报告

为探索简单、安全、可靠的麻醉方法和完美的手术效果。选择合适的门诊病人,在改良的局部肿胀麻醉方法下,进行常规脂肪抽吸术。结果：均取得满意手术效果,无严重并发症发生。结论：１．本文介绍的局部肿胀麻醉方法是一种简便、安全、有效的麻醉方法;２．恰当掌握手术适应证,限制抽吸部位和抽吸量,选择肿胀局麻技术、注意抽吸技巧和术中、术后的塑形及护理等是降低手术并发症,取得更好手术效果的保证。     

应用分流注水器行肿胀麻醉及脂肪抽吸术治疗颈背脂肪垫

目的：手术切除是治疗颈背脂肪垫的传统方法,但术后会遗留大的瘢痕。我们应用分流注水器行肿胀麻醉及脂肪抽吸术治疗颈背部脂肪垫,并评价其疗效。方法：本组12例患者,颈背脂肪垫部位以三通分流注水器注射肿胀液,以负压吸引器带直径2～2.5mm吸脂针抽吸脂肪组织,术后加压包扎。结果：应用分流注水器可减少注水时间并减轻患者痛苦。早期随访,颈肩部外形满意,无血肿、血清肿及皮肤坏死等并发症发生;长期随访,未见颈背脂肪垫复发,相关不适症状消失。结论：以肿胀麻醉及脂肪抽吸术治疗颈背部脂肪垫,创伤小,无并发症,安全有效。应用分流注水器省时省力,且能有效缓解患者痛苦。     

门诊局麻下抽脂89例报告

为探索简单,安全,可靠的麻醉方法和完善的手术效果。选择合适的门诊病人,在改良的局部肿胀麻醉方法下,进行常规脂肪抽吸术。结果;均取得满意手术效果,无严重并发症发生。结论：１．本文介绍的局部肿胀麻醉方法是一种简便,安全,有效的麻醉方法;２．恰当掌握手术适应证,限制抽吸部位和抽吸量,选择肿胀局麻技术,注意抽吸技巧和术中,术后的癃 及护理等降低手术并发症,取得更好手术效果的保证。     

脂肪抽吸术并发症及其防治

脂肪抽吸术是目前治疗皮下局部脂肪堆积的有效方法，肿胀技术、超声辅助技术的发展增加了手术的安全有效性，但同其他手术一样也不可避免地发生并发症，不仅影响手术效果，严重时甚至危及生命。现将目前流行的两种脂肪抽吸方法，即：传统肿胀法脂肪抽吸术与超声吸脂术可能产生的各种并发症综述如下。[第一段]     

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。     

超声辅助脂肪抽吸结合腹壁整形术的体形塑造

目的探讨采用超声辅助脂肪抽吸结合手术去脂行腹壁整形术的临床效果。方法术前站立位，以腹、腰部脂肪明显堆积处为中心用等高线标记脂肪抽吸区；仰卧位采用“夹捏法”确定腹壁整形术的皮肤脂肪切除区。术中先采用超声波体内导入结合肿胀技术吸除非切脂区脂肪，再进行腹壁整形术的皮肤、脂肪切除、腱膜折叠术及脐移位。结果16例术后随访6个月至2年，无感染、皮肤坏死、伤口裂开等并发症发生；并发症较少；术后皮肤回缩明显，术区平坦，感觉恢复快。结论采用体外超声波辅助吸脂结合切脂的腹壁整形术进行腹部体形塑造的临床疗效较佳。     

Experience of Tumescent Liposuction in the Treatment of Osmidrosis

BACKGROUND: Tumescent liposuction is a safe procedure for removal of subcutaneous fat tissue. Because apocrine glands are located deep in the fat, surgical removal of these glands by nontumescent liposuction has been utilized for treating osmidrosis. OBJECTIVE: To evaluate the effect of tumescent liposuction in the treatment of osmidrosis and to compare the efficacy of simple tumescent liposuction and combined tumescent liposuction and curettage. METHODS: A total of 20 patients with osmidrosis (all female, age 16-44 years) were included in this study. Ten patients were treated by simple tumescent liposuction, the other 10 patients were treated by tumescent liposuction combined with curettage. The aspirates were sent for pathologic examination. At a follow-up visit, the improvement of symptoms was graded by the patient as satisfied when the odor decreased> 75%, partially satisfied when it decreased >/=50% to 相似文献   

Tumescent Liposuction Report Performance Measurement Initiative: National Survey Results

BACKGROUND: This study was created by the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement to measure clinical performance and improvement opportunities for physicians and ambulatory health-care organizations. Data were collected prospectively between February 2001 and August 2002. Thirty-nine study centers participated, and 688 patients who had tumescent liposuction were surveyed and followed for 6 months. OBJECTIVE: The objective was to determine patient satisfaction with tumescent liposuction and examine current liposuction practice and the safety of tumescent liposuction in a representative cohort of patients. METHODS: The Accreditation Association for Ambulatory Health Care Institute for Quality Improvement collected prospective data from February 2001 to August 2002 from 68 organizations registered for this study. Ultimately 39 organizations submitted 688 useable cases performed totally with local anesthesia, "tumescent technique." RESULTS: The overall clinical complication rate found in the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement study was 0.7% (5 of 702). There was a minor complication rate of 0.57%. The major complication rate was 0.14% with one patient requiring hospitalization. Seventy-five percent of the patients reported no discomfort during their procedures. Of the 59% of patients who responded to a 6-month postoperative survey, 91% were positive about their decision to have liposuction (rating of 4 or 5 on a scale of 1-5) and 84% had high levels (4 or 5 on a scale of 1-5) of overall satisfaction with the procedure. CONCLUSIONS: Our findings are consistent with others in that tumescent liposuction is a safe procedure with a low complication rate and high patient satisfaction.     

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。     

肿胀吸脂术疗效与并发症分析

目的　探讨肿胀吸脂术的疗效与并发症的预防。方法　应用肿胀技术对 2 69例进行腹部、大腿等部位吸脂术 ,利多卡因总量最大 3 0 0 0mg ,43mg kg ,吸脂最大量为 475 0ml。结果　本组有术后吸脂部位不平、血清肿等并发症 ,但没有出现利多卡因中毒及肺栓塞等严重并发症 ,大部分受术者对术后效果满意。结论　肿胀吸脂术是一种安全有效的减肥方法。术中需注意操作技巧 ,以预防或减少并发症的发生     

应用肿胀吸脂器进行皮下超量灌注吸脂术

目的为减轻皮下超量吸脂术中注射肿胀液时的劳动强度,提高工作效率。方法在25例皮下超量吸脂术使用肿胀吸脂器,其中的连续注液器注射肿胀液,负压泵进行抽吸。结果注液过程缩短,肿胀液充分、均匀,麻醉效果肯定,负压泵吸力大,抽脂量多,术后效果肯定。结论肿胀吸脂器可以连续注液,提高肿胀麻醉工作过程的效率;同时可以负压抽吸,加快了手术过程,是一种全新的吸脂设备。     

Modified Tumescent Liposuction

BACKGROUND: Tumescent liposuction has been found to be safe and effective. However, there are still many refinements that may be possible, such as varying the size and tips of the cannulas, varying the types of infiltrate and associated anesthesia, and the method of compression. OBJECTIVE: To examine possible variables in tumescent liposuction techniques such as the most efficient liposuction cannulas, to determine an effective tumescent fluid, and to examine the extent of compression provided by different garments. METHODS: Patient markings, tumescent fluid formulas, methods of infiltration, types of cannulas, skin incisions, and compression garments were compared between the pure tumescent technique and modified tumescent liposuction. RESULTS: The most efficient cannulas were those with three staggered ports, such as the Mercedes, Cobra-keel, Giorgio Fischer, and Accelerator II tips. When these are combined with modified tumescent fluids and sedation, it is possible to perform total body liposuction in a safe and efficient manner. Multiple ports and compression garments are beneficial to reduce bruising and focal areas of inflammation. CONCLUSION: The tumescent liposuction technique will continue to be improved. So far, with more efficient cannulas and more efficient tumescent fluids, combined with sedation, it has been possible to increase the yield and decrease the required time for the technique. We call this modified tumescent liposuction.     

Ultrasound-assisted lipoplasty: Is it really safe?

During the last decade liposuction has become the most common aesthetic procedure. It has also become the most common aesthetic procedure performed by physicians not trained in plastic surgery. New developments such as the tumescent technique, finer cannulas, and, finally, the technique of ultrasound-assisted lipoplasty (UAL) have been paralleled by reports of larger amounts of extracted fat. At the same time we see an increasing number of fatal complications. I have undertaken an investigation of 28 patients during 16 months, undergoing liposuction with UAL, to find out how the procedure affected them in terms of blood loss. I found that, while undergoing UAL, our patients lost up to 53% of their blood volume on postoperative day 1, and the average patient still had a loss of 20% of the blood volume 1 week postoperatively.     

Clinical and histopathological analysis of tissue retraction in tumescent liposuction assisted by external ultrasound

Multiple subjective evaluations and valuations in clinical studies have suggested that the use of external ultrasound in liposuction favors the degree of tissue retraction. However, studies do not exist that evaluate with objective parameters the degree of tissue retraction after liposuction assisted with external ultrasound. It is for this reason that a comparative clinical trial was carried out in 13 female patients to establish clinically and histopathologically the degree of tissue retraction that is produced after tumescent liposuction assisted by external ultrasound compared with the classic tumescent technique. All patients were tattooed in each hemiabdomen with reference points that formed a 7 x 7-cm square. Abdominal tumescent liposuction was carried out in all patients, with external ultrasound applied to the right hemiabdomen only, and without specifying to the patient the side on which the ultrasound was applied. The areas were measured and biopsies were acquired in each hemiabdomen 72 hours, 1 week, 2 weeks, 3 months, and 6 months postoperatively. The samples were evaluated by the same pathologist in a double-blind study. A survey of the patients was carried out regarding their appreciation of the results at the end of 3 months. On physical evaluation of the tattooed square, none of the thirteen patients presented significant differences in skin retraction (95% dependability by means of Student's t-test). The histological results showed that external ultrasound increased the degree of edema, vascular congestion, and inflammatory infiltration in the dermis during the first 3 months postoperatively. However, after 6 months no differences existed. Clinically, no patient observed a marked difference between the two hemiabdominal areas; an equal aesthetic result was obtained on both sides. In this clinical comparative trial, external ultrasound as a complementary method to tumescent liposuction did not increase the degree of tissue retraction after the liposuction, nor did it prove to be a determining factor in the immediate postoperative evolution.     

超量灌注吸脂术在减少并发症方面的研究

为了探索可以减少并发症的脂肪抽吸术,分别运用超量灌注钝性技术及锐性技术对离体脂肪组织块进行抽吸。通过组织切片观察抽吸后皮下残留结构及脂肪抽吸物的差异。认为正确的选用手术方法及手术器械能保留皮下脂肪组织中的血管、神经、纤维隔,从而可以减少或避免并发症的发生。     

电子吸脂术及其并发症的防治

目的：总结电子吸脂术的临床治疗效果及其并发症预防和治疗经验。方法：在局部肿胀麻醉下，应用医用电子吸脂机对腹部、背部、髂腰部、臀部、腿部、上臂、下颌、颈项等部位进行吸脂塑形术，出现了皮肤瘀斑、血清肿、表皮坏死、局部血肿伴皮肤不平整等并发症。结果：电子吸脂术安全性高、无反弹、术区平整、无切口瘢痕，局部并发症一般不影响吸脂手术的效果。结论：电子吸脂术疗效好，并发症以预防为主，治疗方法简单有效。