国产聚焦超声融脂的临床平行对照研究

目的:研究国产聚焦超声融脂设备临床应用的确切疗效。方法:经伦理委员会批准,应用北京汇福康医疗技术有限公司生产的JCS-01型聚焦超声减脂塑形机,以超声波频率1.9MHz、平均声功率(550±20%)W、在相同治疗方案指导下,采用随机、单盲、阴性对照方法将受试者平均分为2组,实验组发射超声能量,对照组不发射能量,对40例志愿受试者的腹部脂肪堆积部位进行减脂塑形治疗。治疗时受试者仰卧在治疗床上,设备治疗头固定,治疗床按程序自行移动,在设定治疗范围内逐行扫描。每位受试者治疗一次,聚焦超声在腹部扫描3遍,3天后再重复治疗一次,4周后随访。结果:对照、实验两组受试者体重在测量指标均衡可比(P>0.05)的状态下,实验组腹围减少值为(3.48±1.12)cm,对照组腹围减少值为(0.65±0.64)cm,两组间对比具有统计学意义(P<0.05)。治疗过程中有2名受试者出现轻微疼痛和热感,涂抹耦合剂后即刻消失,未见红肿、红斑、紫癜和水疱等不良反应出现。结论:应用聚焦超声进行减脂塑形治疗,临床证明安全有效。     

国产聚焦超声减脂塑形设备临床应用疗效观察

目的：观察国产聚焦超声减脂塑形设备临床应用的疗效。方法：应用北京汇福康医疗技术有限公司生产的JCS-01型聚焦超声减脂塑形机,以超声波频率1.9MHz、平均声功率（550±20%）W、对67例就医者的腹部脂肪堆积部位进行减脂塑形治疗。设备治疗头固定,治疗床按程序自行移动,在设定治疗范围内逐行扫描。每位就医者一次治疗聚焦超声在腹部扫描3遍,3天后再重复治疗一次,4周后随访。结果：有67例门诊就医者接受了聚焦超声减脂塑形治疗,其中,61例完成2次6遍扫描并接受随访,平均腹围减少（3.49±1.66）cm;在此批就医者中,有18例在随访后又接受了第2循环治疗,腹部共承受了4次12遍聚焦超声的扫描,第二次随访时腹围减少（4.64±1.12）cm。治疗过程中,治疗部位未见皮肤红肿、水疱、溃疡。结论：应用聚焦超声进行减脂塑形治疗,临床证明有效。临床治疗效果可以通过增加治疗次数获得加强。     

非侵入性聚焦超声融脂量效动物实验的组织学观察

目的:观察猪皮下脂肪经不同剂量非侵入性聚焦超声照射后的病理学变化。方法:采用由功率0 W、450 W、550W、650W;治疗次数1、2、3组成的9个实验组和1个零剂量对照组,频率1.9MHz的聚焦超声,非侵入照射猪背部皮肤,即刻切取包括皮肤全层并深达肌肉浅层的标本块制作病理切片,HE染色,组织学观察。结果:各实验组脂肪层内,显微镜下可见大量点状脂肪细胞损伤灶。在低、中、高输出功率组,灶内细胞损伤数分别为1～5个、2～10个和15～40个。损伤灶内中央的脂肪细胞消失,边缘的脂肪细胞部分破裂,小血管保存完好,无游离红细胞。未见炭化、组织凝固现象,未见皮肤、肌膜与骨骼肌细胞损伤。结论:1.9MHz非侵入聚焦超声能选择性破坏脂肪细胞,脂肪细胞损伤程度与设备输出功率和照射次数有正相关,具有皮肤、小血管、筋膜等组织的安全性。     

非侵入性聚焦超声辐照活猪皮下脂肪层即刻结果的组织学观察

目的:观察聚焦超声照射活体实验用小型猪皮下脂肪后的组织学即刻表现。方法:采用频率1.9MHz,焦域不大于12mm,平均声功率(550±20%)W的聚焦超声照射猪背部皮下脂肪,即刻切取包括皮肤全层与肌肉浅层的标本块制作病理切片,HE染色,组织学观察。结果:镜下可见脂肪层内存在大量点状脂肪细胞破坏损伤灶。损伤灶有10个细胞大小,灶内脂肪细胞破裂、消失,多个损伤灶可融合成较大损伤区。照射区与损伤灶内均未见出血与游离红细胞,未见皮肤和肌层损伤。结论:脉冲输出的聚焦超声可选择性破坏脂肪细胞。     

非侵入性聚焦超声减脂塑形机临床应用安全性的探讨

目的 探讨临床应用非侵入性聚焦超声减脂塑形机进行塑形治疗的安全性.方法 应用JCS01型非侵入性聚焦超声减脂塑形机,对40例自愿受试者进行随机、盲法、阴性平行对照的临床试验.分别间隔6d对受试者腹部脂肪堆积部位进行2次(每次治疗自动扫描3次)治疗,对治疗时的局部反应进行即时观察和随访,并分别于治疗前及第1次治疗后14d进行肝功能及血脂等多项检查.结果 40例受试者中,36例(实验组与对照组各18例)完成了应用非侵入性聚焦超声减脂塑形机减脂塑形治疗的全部临床试验内容,治疗后局部塑形效果明显,试验组4例受试者自述有局部的微热或轻微的刺痛感,1例受试者末次治疗第7天血甘油三酯(三酰甘油)检查结果升高,2周后再复查恢复正常.其他受试者无局部不良反应,各项实验室检查结果无异常.结论 在2次间隔6d,每次不超过500 cm2的治疗面积下,临床应用非侵入性聚焦超声减脂塑形机进行塑形治疗是安全的.     

聚焦超声减脂塑形机用于腹部减脂塑形的临床观察

目的 探讨聚焦超声减脂塑形机用于腹部减脂塑形的安全性和有效性.方法 选取40例健康受试者,随机分为实验组和对照组,每组20例,按照单盲法实验原则.采用JCS-01型聚焦超声减脂塑形机对受试者的腹部区域做间隔7d的2次治疗.治疗时,固定治疗探头,操作仪器使治疗床按指定区域自行移动.对照组在治疗时调整器械无能量输出.在两次治疗前及治疗后第14天和第35天进行腹围测量、局部拍照以及安全性随访,第35天实验结束时调查受试者满意度.结果 40例受试者中失访1例,其余39例均未发生皮肤红斑、水肿或丘疹,实验室检查未发现有临床意义变化.在治疗后各时间点,实验组中腹围减少＞0.5 cm的受试者,所占的比例均明显高于对照组(P＜0.05).在第35天时两组的腹围减少差异最为显著,20例实验组的受试者中有19例的腹围减少0.83～6.33 cm,平均减少值约3.09 cm,总有效率为95％,受试者满意率为75％.结论 聚焦超声减脂塑形机具有较高安全性,用于腹部减脂塑形有一定效果.     

超声去脂塑形仪的临床应用

应用国产ＺＵＬＳ超声去脂塑形塑形仪治疗不同部位局部皮下脂肪堆积肥胖患者４２例次，总结了其成功的关键和疗效评价标准。通过４２例的疗效分析认为，超声去脂塑形术疗效确切、手术安全、术后形态恢复好，值得推广应用。同时指出该术也有局限性，须进一步探讨改进。     

临床应用聚焦超声减脂塑形治疗的有效性研究

目的 探讨临床应用聚焦超声减脂塑形治疗的有效性.方法 采用随机、双盲、阴性平行对照的临床试验方法,应用聚焦超声减脂塑形机,对40例自愿受试者的腹部脂肪堆积部位进行减脂治疗.治疗于受试者入组的第1、7天进行,每次对治疗部位进行3次聚焦超声的扫描.随访时间为试验的第1、7天治疗后即刻以及试验的第14、35天,测量指标包括腹围及影像资料等.结果 36例受试者完成了聚焦超声减脂塑形2次(6遍)的局部治疗及随访.试验组受试者2次治疗后腹围分别减少了(1.03±0.38)cm、(0.65±0.53)cm,第14、35天随访腹围较治疗前分别减少了(2.52±1.04)cm、(3.31±0.67)cm,与对照组相比,差异有统计学意义(P ＜0.05).结论 研究证明,聚焦超声减脂塑形治疗有效.     

非侵入性减脂塑形方法概述

长期以来,减脂塑形是整形美容外科最受欢迎的操作之一,随着科技的发展,人们更倾向于不通过外科手术,即通过非侵入性方法达到对于美和健康的追求,故应用各类仪器设备的非侵入性减脂塑形技术满足了广大求美者的要求,并已成为目前最热门的整形美容外科领域之一[1-3]。本文主要就各     

聚焦超声消融治疗胰腺癌的临床观察

目的探讨高强度聚焦超声(high intensity focused ultrasound,HIFU)消融治疗胰腺癌的疗效和安全性.方法采用JC型高强度聚焦超声治疗系统,消融治疗44例胰腺癌患者.观察治疗前后的影像学变化及临床症状,评价HIFU治疗的疼痛缓解程度、生存期及不良反应.结果44例患者经HIFU治疗后,疼痛缓解率为94.74%,1、3、5年生存率分别为15.91%、6.82%、2.27%,中位生存时间为8个月(3～71个月).无上消化道出血或胃肠穿孔等严重并发症.增强CT或MRI显示HIFU治疗区内组织消融.结论HIFU是一种治疗胰腺癌的有效方法.该法无创、安全性较高、止痛效果明显,适合病情较重、不能耐受其他方法治疗的患者.     

Body contouring by non-invasive transdermal focused ultrasound

BACKGROUND AND OBJECTIVES: The risks of currently available invasive procedures in body contouring motivate a need for safer, non-invasive technologies for improving the appearance of body silhouette. A new device has been developed that uses focused therapeutic ultrasound to reduce adipose tissue non-invasively. The aim of this study was to assess the efficacy and safety of a novel non-invasive focused ultrasound system (UltraShape Ltd, Tel Aviv, Israel) in reducing localized fat deposits to improve body contours. STUDY DESIGN/PATIENTS AND METHODS: A prospective study was conducted on 30 healthy patients. All patients underwent three treatments, at 1-month intervals, and were followed for 1 month after the last treatment. Areas treated were the abdomen, inner and outer thighs, flanks, inner knees, and breasts (males only). No other body contouring procedure was used during the study. Efficacy was determined by change in fat thickness, assessed by ultrasound measurements, and by circumference measurements. Weight change was monitored to assess whether reduction in fat thickness or circumference was dependent on or independent of weight loss. Safety was determined by clinical findings, assays of serum triglycerides, and liver ultrasound evaluation for the presence of steatosis. RESULTS: All patients showed significant reduction in subcutaneous fat thickness within the treated area. The mean reduction in fat thickness after three treatments was 2.28+/-0.80 cm. Circumference was reduced by a mean of 3.95+/-1.99 cm. Weight was unchanged during the treatment and follow-up period. No adverse effects were observed. CONCLUSIONS: This study shows the efficacy and safety of focused ultrasound, using the UltraShape Contour I, as a non-invasive transdermal method for reducing unwanted fat deposits in the body. Multiple treatments combined with appropriate patient and treatment area selection can produce dramatic improvements in body contour.     

Composite Body Contouring

Background  Aesthetic surgery of the thoracoabdominal region is one of the most frequently performed surgical procedures in plastic surgery.The combination of circumferential liposuction, autologous fat grafting of the buttocks and/or lower limbs, and the modified transverse abdominoplasty as an adjuvant procedure all done in a single surgical procedure is not very common. The authors present a prospective study of the surgical technique of composite body contouring, emphasizing the low rate of complications and the high overall patient satisfaction. Methods  A total of 64 consecutive female patients were operated on between January 2004 and January 2007. All the patients who were included in the study were candidates for a classical abdominoplasty. Posterior and lateral syringe-assisted liposuction combined with fat insertion into the buttocks and/or lower limbs was performed. Autologous fat grafting was done in the gluteal area for buttocks enhancement and in the lower limbs to correct contour deformities. Anterolateral liposuction with modified transverse abdominoplasty was done as an adjuvant procedure. Overall satisfaction with body appearance after composite body contouring was rated on a scale of 1–5. Results  From 1,500 to 4,600 ml of fat was obtained with liposuction (mean = 2,478 ml). Forty-five patients had fat grafting only to the buttocks area. Six patients had fat insertion into the lower limbs and 13 had fat injection into the buttocks and lower limbs. The amount of fat transplanted to the buttocks varied from 165 to 625 ml (mean = 346 ml) and to the lower limbs it varied from 75 to 270 ml (mean = 195 ml). Three patients (5%) suffered from early complications, including infection (3%) and hematoma formation (2%). Nine patients (14%) had late complications, including hypertophic scars (7.5%), dog ears (4.5%), and localized fat excess (2%). Nine patients (14%) underwent revision surgery. Sixty-three percent reported that their appearance after composite body contouring was “very good” (42%) or “excellent” (21%) and 27% responded that their appearance was “good.” Only 10% thought their appearance was less than good, (7% “fair” and 3% “poor”).The average follow-up time has been 3.2 years (range = 2–5 years). Conclusion  Composite body contouring combines circumferential liposuction, fat grafting of the buttocks and lower limbs, and modified transverse abdominoplasty to accomplish very good aesthetic results in a single surgical procedure with a low rate of complications and high patient satisfaction.     

Gender Incongruence: Gender Affirming Body Contouring and Physical Transformation in Transgender Individuals

There is a subset of transgender individuals, who after having undergone gender affirming surgeries want body contouring so that the overall body shape is congruent to the body image. Hormonal therapy can bring about a considerable change in the physical transformation. However, there is an increase in requests for specific body contouring procedures because of increased awareness in the society.There are significant differences between the skeletal as well as soft tissue characteristics of male and female body. Body contouring in transgender individuals can be achieved by altering the skeletal structure or the overlying soft tissues or combining both. In this article, we discuss body contouring as an adjunct to gender affirming surgeries, in both male to female and female to male transgender individuals.     

Attitudes of Morbidly Obese Patients to Weight Loss and Body Image following Bariatric Surgery and Body Contouring

Background The authors evaluated body image attitudes in post-obese persons following bariatric surgery who require cosmetic and body contouring operations. Methods We studied 20 morbidly obese women prior to biliopancreatic diversion (BPD) (OB group), 20 post-obese women at >2 years following BPD (POST group), 10 post-obese women following BPD who required cosmetic procedures (POST-A group), 10 post-obese women after BPD and subsequent cosmetic surgery (POST-B group), and 20 healthy lean controls. Attitudes to weight and shape were evaluated by means of the Body Uneasiness Test (BUT). Results In comparison with the obese patients in the POST group, lower BUT scores were observed, while in the POST-A group the values were very similar to those observed in the non-operated obese individuals. In the individuals having received cosmetic surgery, the BUT findings were similar to those recorded in the POST group patients, the values approaching data found in the controls. Conclusion Despite a fully satisfactory weight loss and maintenance, the post-BPD individuals requiring aesthetic surgery showed some disparagement of body image; in these subjects, cosmetic and body contouring procedures may actually improve body weight and shape attitudes towards normality.     

The Desire for Body Contouring Surgery after Bariatric Surgery

Background  Obesity has become far more prevalent over the last few decades. In parallel, bariatric surgery has been increasingly utilized as a method of treatment. This appears to be having an impact on the rate of body contouring surgery for hanging redundant skin after the massive weight loss that usually results from bariatric surgery. Little literature is available addressing how frequently patients who have undergone bariatric surgery receive or desire body contouring surgery or regarding how satisfied these patients are with the hanging skin in certain body areas. Methods  Seventy individuals (out of 250 who were mailed the questionnaire) who had undergone Roux-en-Y gastric bypass surgery 6–10 years previously completed a questionnaire, which obtained information regarding their experiences with as well as their desire for body contouring surgery and more general body area satisfaction. Results  Thirty three of the seventy patients reported having undergone a total of 38 body contouring procedures. The most common were abdominoplasties (24.3%), breast lifts (8.6%), and thigh lifts (7.1%). However, subjects were not uniformly satisfied with body areas that had undergone body contouring surgery; some found the areas unattractive. The majority of patients, at least to some extent, desired body contouring surgery, often in several areas, most notably the waist/abdomen, rear/buttock, upper arms, and chest/breast. Conclusion  Paralleling the increasing use of bariatric surgery is an increasing desire for body contouring surgery. Most patients desire body contouring surgery after bariatric surgery. However, third party payors usually do not reimburse for such procedures.