Effect of different fat purification methods on scar pain after breast surgery
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摘要:目的 通过不同脂肪获取及脂肪纯化方法，并采用自体脂肪移植术（AFG）治疗瘢痕相关疼痛，总结AFG在脂肪获取及提纯中的治疗经验。方法 将115例研究对象随机分为治疗组（58例）和对照组（57例），治疗组进一步分为A组、B组、C组和D组。A组（n=16）采用干抽法和离心法，B组（n=13）采用干抽法和静置法，C组（n=14）采用湿抽法和离心法，D组（n=15）采用湿抽法和静置法，对照组57例患者无特殊治疗。观察AFG在瘢痕相关疼痛中的治疗效果，比较治疗前后视觉模拟评分法（VAS）评分和治疗后满意度调查情况，总结AFG在脂肪获取及提纯中的治疗经验。结果 治疗后，A、B、C、D组VAS评分均较治疗前降低，且低于对照组，差异有统计学意义（P＜0.001）。治疗组各组满意度评分均高于对照组，差异有统计学意义（P＜0.001）。结论 AFG技术在乳腺手术后瘢痕疼痛中的疗效显著。在脂肪获取过程中，是否注射肿胀液，选择离心法或静止法均不影响治疗效果。Abstract:Objective To treat scar-related pain with Autologous fat transplantation(AFG) through different methods of fat acquisition and fat purification, sum up the treatment experience of AFG in fat acquisition and purification.Methods A total of 115 patients were randomly divided into treatment group (n=58) and control group (n=57), treatment group were further divided into groups A, B, C and D. The group A (n=16) received dry pumping and centrifugal method, the group B (n=13) received dry pumping and static method, the group C (n=14) received wet pumping and centrifugal method, and the group D (n=15) received wet pumping andstatic method. Patients in the control group(n=57) received no special treatment. The therapeutic effects of AFG in scar related pain were observed, the Visual Analog Scale (VAS) score before and after treatment and the satisfaction degree by survey after treatment were compared, and the therapeutic experience of AFG in fat acquisition and purification was summarized.Results After treatment, VAS scores of groups A, B, C and D were lower than those before treatment and the control group (P < 0.001). The satisfaction scores of each group of the treatment group were higher than that of the control group (P < 0.001).Conclusion AFG technique is effectivein scar pain after breast surgery. In the process of fat acquisition, injecting swelling fluid or not, centrifugal method or static method all have no influence on therapeutic effects.
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Keywords:
- autologous fat grafting /
- breast surgery /
- scar pain /
- fat purification /
- clinical effect
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表 1 患者基线资料比较(x±s)
基线资料 治疗组(n=58) 对照组(n=57) A组(n=16) B组(n=13) C组(n=14) D组(n=15) 平均年龄/岁 40.81±5.27 41.46±6.63 40.57±6.65 41.87±5.29 41.25±6.37 平均瘢痕时间/月 26.94±6.81 26.08±6.91 26.43±6.03 26.80±5.58 26.75±5.63 平均瘢痕长度/cm 4.19±0.97 3.98±0.89 4.19±0.74 4.13±0.96 4.16±0.85 平均疼痛评分/分 5.06±1.39 5.08±1.38 5.15±1.29 5.13±1.36 5.04±1.32 婚姻状态 已婚 14 11 12 13 46 未婚 2 2 3 2 11 既往疾病 乳腺良性肿瘤 10 9 7 9 38 乳腺炎性疾病 4 3 6 3 13 乳腺恶性肿瘤保乳 2 1 1 3 6 
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表 2 各组治疗前后VAS评分比较(x±s)
分 时点 治疗组(n=58) 对照组(n=57) A组(n=16) B组(n=13) C组(n=14) D组(n=15) 治疗前 5.06±1.39 5.08±1.38 5.15±1.29 5.13±1.36 5.04±1.32 治疗后 2.44±0.89*# 2.46±0.78*# 2.43±0.94*# 2.27±0.96*# 5.02±1.43 与治疗前比较, * P＜0.05; 与对照组比较, #P＜0.05。
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