人源脂肪干细胞胶注射治疗贴骨瘢痕的临床疗效分析

李小兵; 杨茹茜; 江波; 刘星可; 刘兰; 杨超; 王雪; 颜洪

doi:10.16016/j.1000-5404.202101127

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人源脂肪干细胞胶注射治疗贴骨瘢痕的临床疗效分析

专题报道：皮肤创面与瘢痕修复研究 | 更新时间：2026-01-09

- 人源脂肪干细胞胶注射治疗贴骨瘢痕的临床疗效分析
- Preparation of gel containing human adipose derived stem cells and its clinical efficacy for adherent scar
- 第三军医大学学报 2021年43卷第11期页码：1018-1024
- 作者机构：
  
  646000 四川泸州，西南医科大学附属医院整形烧伤外科，国家临床重点建设专科，创面修复与再生实验室
- 作者简介：
  
  [颜洪，E-mail: huaxi90@126.com YAN Hong, E-mail: huaxi90@126.com
- 基金信息：
  
  利益冲突声明本文作者与论文刊登的内容无利益冲突
- DOI：10.16016/j.1000-5404.202101127
  中图分类号： R329.24;R619.6;R969.4
- 收稿：2021-01-14，
  
  修回：2021-03-15，
  
  纸质出版：2021-06-15
- 稿件说明：
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李小兵, 杨茹茜, 江波, 等. 人源脂肪干细胞胶注射治疗贴骨瘢痕的临床疗效分析[J]. 第三军医大学学报, 2021,43(11):1018-1024.

Xiaobing LI, Ruqian YANG, Bo JIANG, et al. Preparation of gel containing human adipose derived stem cells and its clinical efficacy for adherent scar[J]. Journal of Third Military Medical University, 2021, 43(11): 1018-1024.
李小兵, 杨茹茜, 江波, 等. 人源脂肪干细胞胶注射治疗贴骨瘢痕的临床疗效分析[J]. 第三军医大学学报, 2021,43(11):1018-1024. DOI： 10.16016/j.1000-5404.202101127.

Xiaobing LI, Ruqian YANG, Bo JIANG, et al. Preparation of gel containing human adipose derived stem cells and its clinical efficacy for adherent scar[J]. Journal of Third Military Medical University, 2021, 43(11): 1018-1024. DOI： 10.16016/j.1000-5404.202101127.

摘要

目的

探讨含人源脂肪干细胞的血管基质组分胶(stromal vascular fraction-gel，SVF-gel)对贴骨瘢痕治疗的临床效果。

方法

回顾性分析本科室2018年6月至2020年6月收治的符合入选标准采用SVF-gel注射治疗的贴骨瘢痕患者的临床资料。SVF-gel由患者腹部或大腿皮下抽吸的脂肪经机械乳化处理获得，于患者贴骨瘢痕区域注射(穿刺隧道内间隔2 mm注入0.02 mL SVF-gel)，留取少量等体积颗粒脂肪与SVF-gel进行体外消化培养及鉴定。术前及术后6个月检测患者瘢痕硬度与厚度；采用患者和观察者瘢痕评价量表(patient and observer scar assessment scale

POSAS)评估瘢痕情况，并统计患者满意度情况。

结果

共入选8例患者，累计10处贴骨瘢痕；凹陷区域面积: (5.56±4.50)cm

；贴骨瘢痕下SVF-gel注射量(3.90±3.00)mL。SVF-gel与颗粒脂肪经消化后培养均可见短梭形细胞生长，经细胞表型鉴定，间充质干细胞(mesenchymal stem cells，MSC)特异性标志物CD73、CD90、CD105表达率均大于95%；同时间同体积的SVF-gel经消化后培养的原代细胞数明显多于颗粒脂肪；且细胞经体外诱导培养可见脂肪样细胞生长，油红O染色阳性。比较术前与术后6个月瘢痕情况，瘢痕硬度由(48.13±20.59)邵氏单位减小为(30.96±15.66)邵氏单位，差异有统计学意义(

0.05)；瘢痕皮肤厚度由(2.00±0.60)mm增加为(2.72±0.63)mm，差异有统计学意义(

0.05)。术后6个月，患者瘢痕皮肤外观及活动度显著改善，均无并发症发生；患者评估量表(patient scar assessment scale

PSAS)和观察者评估量表(observer scar assessment scale，OSAS)评分分别为(12.0±2.8)分和(13.7±3.9)分，患者满意度评分为4~5分，平均4.6分。

结论

颗粒脂肪经机械处理后形成的SVF-gel内含更多活性脂肪干细胞；贴骨瘢痕经SVF-gel注射治疗后局部凹陷减轻，患者满意度较好。

Abstract

Objective

To investigate the clinical effectiveness of stromal vascular fraction gel (SVF-gel) containing human adipose derived stem cells (ADSCs) in the treatment of adherent scar.

Methods

A retrospective analysis was carried out on the patients with adherent scars meeting our inclusion criteria and undergoing the treatment of gel injection during June 2018 and June 2020. The SVF-gel was prepared from the lipoaspirates sucked from the abdomen or the thigh followed by filtration

centrifugation and emulsion

and then injected into the adherent scars (at an interval of 2 mm for every needle puncture

SVF-gel 0.02 mL for every dose). Small amount of granular adipose tissues and SVF-gel were digested

cultured and identified. The scar hardness and thickness were measured for every patient preoperatively and 6 months postoperatively. Patient and observer scar assessment scale (POSAS) was used to evaluate scar condition

and patient satisfaction was investigated.

Results

There were 8 patients enrolled in this study

with a total of 10 adherent scars and the area of depression of 5.56±4.50 cm

. The injection volume of SVF-gel under the adherent scar was 3.90±3.00 mL. The results of morphological observation showed that short spindle cells grew in both SVF-gel and granular fat after digestion

and the over 95% obtained cells expressed the specific markers of mesenchymal stem cells

CD73

CD90 and CD105. At the same time

the number of primary cells cultured in same volume of SVF-gel was larger than the number from the granular fat tissue. Differentiation study found the growth of adipose-like cells

in vitro

which were positive to oil red O staining. The scar hardness was decreased from 48.13±20.59 shore units preoperatively to 30.96±15.66 shore units in 6 months postoperatively(

0.05)

and the scar skin thickness was increased from 2.00±0.60 mm to 2.72±0.63 mm (

0.05). In 6 months after operation

the appearance and activity of scar skin were significantly improved

and no complications were observed. The scores of patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS) were 12.0±2.8 and 13.7±3.9 respectively

and the patient satisfaction score was 4 to 5

with an average of 4.6.

Conclusion

Our prepared SVF-gel contains more active ADSCs. Its injection can improve the local depression and scar texture in the adherent scar and achieve good satisfaction in the patients.

关键词

Keywords

references

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