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中华医学美学美容杂志
中华医学美学美容杂志

彭庆星

双月刊

1671-0290

cmac9@vip.sohu.com

010-66352462

100120

北京市安外黄寺大街9号

中华医学美学美容杂志/Journal Chinese Journal of Medical Aesthetics and CosmetologyCSTPCD
查看更多>>中华医学会主办。本刊是以医学美学与美容学的基础理论研究和临床应用为重点的高级学术刊物,是面向中高级医学美学与美容学专业人员为主的学术性期刊。本刊专业领域涵盖美容外科,整形外科,美容皮肤科,美容牙科,和医学美容。刊登美容外科、美容皮肤科、美容牙科、美容内科、物理美容、药物美容、中医美容和美容护理等研究和应用。栏目有：临床论著、实验研究、医学美学、经验总结、病例报告、技术革新、综述、讲座，继续教育园地等。
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    眉下切口提眉术中眼轮匝肌瓣填充矫正上睑凹陷的效果

    刘恒鑫王嘉阳牟思琦张仔昂...
    56-60页
    查看更多>>摘要：目的 探讨眉下切口提眉术中，采用中央下蒂法眼轮匝肌瓣折叠填充矫正上睑凹陷的效果。 方法 2020年8月至2022年4月，空军军医大学第一附属医院整形外科收治上睑皮肤松弛伴凹陷的女性患者39例，年龄36～63(47.1±6.3)岁。提眉术中保留皮肤切除区域眼轮匝肌，并形成以切口下缘中央部为蒂的肌瓣，向深面反折填充于眶隔前间隙，术后6个月采用Park法分级标准比较手术前后效果，并分别由医师和患者按全球审美改善量表进行评分。 结果 术后1例患者出现单侧上睑血肿，局部针刺抽吸后愈合。2例患者出现单侧切口单发硬结，随访6个月逐渐消失。其余患者伤口均一期愈合。39例患者均随访6～12个月，术后6个月全球审美改善量表评分显示，医师(4.12±0.95)分、患者(3.82±1.27)分；Park法评估显示术后上睑凹陷矫正程度明显优于术前，差异有统计学意义(Z＝－7.72，P<0.001)。 结论 眉下切口提眉术中用中央下蒂法眼轮匝肌瓣折叠填充能在矫正上睑皮肤松弛的同时较好地改善患者上睑凹陷，该术式能充分利用局部组织，简单易行，效果确切持久。 Objective To investigate the effect of folding and filling the orbicularis muscle flap of the inferiorcentral pedicle in correction of sunken upper eyelids. Methods From August 2020 to April 2022, 39 female patients aged 36-63 (47.1±6.3) years with dermatochalasis and sunken upper eyelid were admitted to the Plastic Surgery Department of the First Affiliated Hospital of Air Force Medical University. During the surgery, the orbicularis oculi muscle in the skin resection area was preserved and a muscle flap was formed with the central part of the lower margin of the incision as the pedicle, which was folded deep and filled in the anterior orbital septal space. 6 months after surgery, the Park method was used to compare the effects before and after surgery, and the doctors and patients were scored on the Global Aesthetic Improvement Scale, respectively. Results Unilateral upper eyelid hematoma appeared in 1 patient and healed after local acupuncture and aspiration, unilateral incision induration appeared in 2 patients, and gradually disappeared after 6 months of follow-up. The wounds of other patients healed in one stage. All the 39 patients were followed up for 6-12 months. The scores of the Global Aesthetic Improvement Scale at 6 months after surgery were (4.12±0.95) for doctors and (3.82±1.27) for patients. Park method showed that the degree of sunken upper eyelid after surgery was significantly better than that before surgery, and the difference was statistically significant (Z=-7.721, P=0.000). Conclusions The folding and filling of the orbicularis muscle flap of the eye with the inferior central pedicle can correct the laxity of the upper eyelid and improve the sunken upper eyelid. This operation can make full use of local tissue, and the effect is simple and lasting.

    眼睑成形术中央下蒂眼轮匝肌瓣上睑凹陷皮肤松弛

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    下睑眼袋内入路眶隔脂肪团取出处理后回填矫正泪沟及睑颊沟畸形的效果

    王咏民杜太超王涛金威...
    61-64页
    查看更多>>摘要：目的 探讨下睑眼袋内入路眶隔脂肪取出处理后回填矫正泪沟及睑颊沟畸形的效果。 方法 2019年11月至2022年9月，北京黄寺医疗美容门诊部美容外科行下睑眼袋内入路眶隔脂肪团块取出后颗粒化处理，回填矫正泪沟及睑颊沟凹陷畸形患者42例，男13例、女29例；年龄16～47(23.8±6.9)岁。患者均存在不同程度的眶隔脂肪膨出，轻、中、重度泪沟和睑颊沟凹陷畸形，下睑皮肤不松弛。经下睑结膜切口入路，将自然疝出的眶隔脂肪团剪除，颗粒化处理后装入1 ml注射器中，依据术前划线标记的凹陷区，精准填充至泪沟和睑颊沟凹陷的区域。术后随访3个月，观察手术效果及不良反应。 结果 42例患者切口均一期愈合，无血肿感染；2例患者出现皮下瘀斑，48 h后局部热敷，1周瘀斑消退。分别在术后1、2、3个月随访，其中35例患者术后效果满意，眼袋膨出及睑颊沟、泪沟凹陷症状消失。7例眼袋伴泪沟及睑颊沟患者，由于眶隔脂肪量不足，还有轻微凹陷，术前已告知可能需要2次脂肪填充，1个月后于腿部取脂肪颗粒填充泪沟、睑颊沟凹陷，效果满意。 结论 下睑内路眼袋眶隔脂肪团取出后处理并回填矫正泪沟及睑颊沟畸形的临床操作简单，手术后满意度高，值得临床应用。 Objective To investigate the effect of backfilling on the deformity of lacrimal sulcus and blepharobuccal sulcus after special treatment of the fat from orbital septum of the pouch in the lower intra-palpebral approach. Methods From November 2019 to September 2022, a total of 42 patients (13 males and 29 females) aged 16-47(23.8±6.9) years with orbital septal fat swelling were treated by the surgical department of Beijing Huangsi Medical Cosmetic Clinic after the removal of orbital fat mass by the intraocular pouch approach. With mild, moderate, and severe lacrimal sulci and blepharobuccal depression deformity, the lower eyelid skin was not relaxed. The naturally herniated orbital septal adipose mass was cut off through the lower eyelid conjunctival incision approach, and then granulated into a 1 ml syringe, which was accurately filled into the depressed area of lacrimal sulci and blepharobuccal sulci according to the depressions marked before surgery. Results The incisions of all 42 patients healed in the first stage without hematoma and infection, and the subcutaneous ecchymosis of 2 cases was observed by local hot compress 48 h later and the ecchymosis subsided 1 week. Follow-up was performed at 1 month, 2 months and 3 months, respectively. Among them, 35 patients underwent the operation of removing the lower eyelid bag and orbital septum cellulite and backfilling to correct the malformation of lacrimal sulci, and the postoperative effect was satisfactory. The symptoms of puffed eye bags, blepharobuccal sulci and lacrimal sulci depression disappeared, and the wound healed in one stage. 7 patients with eye bags accompanied by lacrimal sulci and blepharobuccal sulci were told before surgery that they might need two fat fillings due to insufficient fat content in the orbital septa and slight indentations. One month later, granular fat was taken from the legs to fill the lacrimal sulci and blepharobuccal sulci with satisfactory results. Conclusions The treatment after the removal of orbital septum cellulite and the correction of lacrimal sulcus and blepharobuccal sulcus deformity are simple and satisfactory, and worthy of clinical application.

    眼睑下睑眼袋眶隔脂肪泪沟畸形

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    超皮秒1 064 nm激光治疗面部毛孔粗大的效果

    韩小雪周明郭乔娜刘成波...
    65-68页
    查看更多>>摘要：目的 评估超皮秒1 064 nm激光治疗面部毛孔粗大的疗效及安全性。 方法 2022年11月至2023年4月，于西安国际医学中心医院医学美容中心就诊的面部毛孔粗大女性患者31例，年龄28～52(35.2±5.5)岁。用超皮秒1 064 nm激光点阵手具治疗，每4周1次，共3次；末次治疗后1个月，通过面部毛孔评分、VISIA毛孔特征计数绝对值评估面部毛孔变化，并评估不良反应。 结果 31例患者均完成治疗，治疗前、后患者面部毛孔评分分别为4(4，5)、2(2，3)分，面部毛孔评分较治疗前下降，差异有统计学意义(Z＝－4.99，P<0.001)。治疗前、后VISIA面部毛孔计数绝对值分别为859(829，1 147)、652(632，731)，患者治疗后VISIA毛孔计数绝对值较治疗前下降，差异有统计学意义(Z＝－4.86，P<0.05)。 结论 超皮秒激光能有效改善面部毛孔粗大，未发生明显不良反应。 Objective Evaluation of the efficacy and safety of ultra-picosecond 1 064 nm laser treatment for enlarged facial pores. Methods From November 2022 to April 2023, 31 female patients with enlarged facial pores, aged between 28 and 52 (35.2±5.5) years old, were treated at the Medical Aesthetics Center of Xi′an International Medical Center Hospital. They received ultra-picosecond 1 064 nm laser fractional handpiece treatment once every 4 weeks for a total of 3 times. One month after the last treatment, facial pore changes were evaluated using facial pore scores and VISIA pore feature count absolute values, and adverse reactions were assessed. Results All 31 patients completed the treatment. The facial pore scores before and after treatment were 4 (4, 5) and 2 (2, 3), respectively, indicating a statistically significant (Z=-4.99, P<0.001) decrease in facial pore scores compared to before treatment. The absolute values of VISIA facial pore counts before and after treatment were 859 (829, 1147) and 652 (632, 731), respectively. The absolute value of VISIA pore count after treatment was lower than that before treatment, and the difference was statistically significant (Z=-4.86, P<0.05 ). Conclusions Ultra-picosecond laser can effectively improve enlarged facial pores without significant adverse reactions.

    激光毛孔粗大超皮秒激光VISIA疗效和安全性

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    注射透明质酸填充剂VYC-20L在面部年轻化的有效性和安全性

    黄高敏许富杰刘烨周杰...
    69-73页
    查看更多>>摘要：目的 探讨透明质酸填充剂VYC-20L在美容就医者全面部年轻化的有效性和安全性。 方法 2020年11月至2021年11月，上海静和门诊部、上海沃德医疗中心、七和医疗美容医院、秦皇岛巧致美容医院就诊的美容就医者216例，男37例、女179例，年龄25～67(41.4±10.9)岁。根据需求用"ROYGBbP彩虹提升法"注射透明质酸填充剂VYC-20L，于注射前、注射后1、6、12个月随访时评估效果，用全球审美改善量表评分(GAIS)及治疗满意度进行评分。记录注射时和注射后出现的不良反应。 结果 注射后1、6、12个月，分别有203例(94.0%)、208例(96.3%)、205例(94.9%)美容就医者"改善优秀"或"改善很多"。注射后12个月，216例美容就医者的全面外观满意度及外观认同度评分均显著提升(均P<0.01)。注射后1、6、12个月分别有197例(91.2%)、198例(91.7%)、198例(91.7%)美容就医者对治疗感到"非常满意"或"比较满意"。最常见的治疗部位不良反应为胀痛、瘀斑、水肿、皮肤发红等，多数症状轻微，持续时间≤2周。 结论 美容就医者注射VYC-20L提升全面部安全、有效，能显著改善面部松弛下垂，使面部年轻化，效果可维持12个月。 Objective To explore the efficacy and safety of hyaluronic acid filler VYC-20L for full-face lifting in aesthetic seeking patients. Methods Between November 2020 and November 2021, a total of 216 aesthetic seeking patients were enrolled in Shanghai Chingho Outpatient Department, World Path Clinic International, Qihe Medical Beauty Hospital and Qinhuangdao Qiaozhi Beauty Hospital, including 37 males and 179 females, aged 25-67 (41.42±10.93) years. According to the needs and requirements, the novel injection technique of " ROYGBbP-rainbow lifting method" was used to inject hyaluronic acid filler VYC-20L. The global aesthetic improvement scale (GAIS) and the treatment satisfaction questionnaires were scored and evaluated before the injection, and at follow-up visits 1, 6, and 12 months after the injection. Any adverse reaction or adverse events presenting or reported by the patients post-injection were recorded. Results At 1 month, 6 months and 12 months after the injection, about 203 (94.0%), 208 (96.3%) and 205 (94.9%) of the aesthetic seeking patients rated their full-face appearance as " excellently improved" or " much improved" on the GAIS, respectively. And 12 months after the injection, the overall facial satisfaction scores and appearance recognition scores of all aesthetic seeking patients were all significantly higher than those before injection ( P<0.01). 197 (91.2%), 198 (91.7%) and 198 (91.7%) of the aesthetic seeking patients were " very satisfied" or " relatively satisfied" with the treatment at 1 month, 6 months and 12 months, respectively. Treatment site responses most frequently reported were tenderness, bruising, topical swelling and skin redness. Most of the symptoms were moderate or mild feeling, lasting for no more than two weeks. Conclusions The application of hyaluronic acid filler VYC-20L is safe and effective for full-face lifting in aesthetic seeking patients, which can significantly improve facial sagging and rejuvenate the face. The effect of improvements can last for 12 months.

    面部透明质酸注射面部提升年轻化全球审美改善评分

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    透明质酸钠复合溶液不同注射方法改善眶周老化的效果

    迟斌山白婵婵
    74-76页
    查看更多>>摘要：目的 探讨下睑透明质酸钠复合溶液不同注射方案改善眶周老化的效果。 方法 2021年9月至2022年6月，南京医科大学友谊整形外科医院整形外科及南京医科大学友谊整形外科医院泰州医疗美容门诊部收治要求下睑年轻化的美容就医者86例，男2例、女84例，年龄20～58(34.3±7.3)岁。分为两组，钝针组(68例)用25 G钝针在眶颧沟外侧和泪沟延长线颊中沟外侧做2个进针点，在肌肉下深层脂肪垫及皮下浅层分别进行适量注射；锐针组(18例)用30 G锐针，直接垂直皮肤顶至泪沟、睑颧沟相应区域的眶骨弓状缘骨膜上及皮下浅层脂肪进行注射。观察美容就医者治疗效果和眶周瘀斑、肿胀等并发症。 结果 钝针组68例患者中均表现泪槽沟及睑颧沟明显改善，眼周实现年轻化，有4例出现点状瘀斑，1例患者满意度欠佳，其余患者均较为满意。锐针组18例患者均有泪沟及睑颧沟改善，其中6例出现瘀斑，其中有2例瘀斑弥散范围较大并表示不满意，其余患者对治疗结果较满意。 结论 钝针组和锐针组均能不同程度地改善泪槽沟凹陷和睑颧沟凹陷，实现眶周年轻化，但钝针组治疗方案相较于锐针组在下睑年轻化治疗中出现瘀斑等并发症概率更低。 Objective To explore the effect of different injection schemes on improving lower eyelid rejuvenation and avoiding complications such as ecchymosis around the orbit. Methods From September 2021 to June 2022, 86 patients who underwent lower eyelid rejuvenation at the Plastic Surgery Department of Nanjing Medical University Friendship Hospital and Taizhou Medical Cosmetic Clinic of Nanjing Medical University Friendship Plastic Surgery Hospital were included in this study. There were 2 males and 84 females, aged 20-58 (34.27±7.27) years. The patients were divided into two groups: the Cannula Group (68 cases) received appropriate injections under the deep layer of muscle fat pad and superficial layer of subcutaneous tissue using a 25 G cannula at two entry points on the lateral orbital zygomatic groove and the extension line of tear trough buccal groove the Needle Group (18 cases) received injections directly perpendicular to the skin top to the orbital arch border of the corresponding area of tear trough and eyelid commissure fossa and superficial layer of subcutaneous fat using a 30G needle. The therapeutic effects and complications such as periorbital ecchymosis and swelling were observed in both groups. Results In the Cannula Group, all 68 patients showed significant improvement in tear trough groove and eyelid commissure groove, achieving eyelid rejuvenation. Four patients developed spotty ecchymosis, and one patient was dissatisfied with the treatment outcome. The other patients were satisfied with the results. In the Needle Group, all 18 patients showed improvement in tear trough groove and eyelid commissure groove, with 6 patients developing ecchymosis. Two patients with large range of ecchymosis expressed dissatisfaction, while the rest were satisfied with the treatment outcome. Conclusions Tear trough groove depression and eyelid commissure groove depression have been improved to varying degrees in both the Cannula Group and the Needle Group, achieving periorbital rejuvenation. However, the Cannula Group has a lower probability of complications such as ecchymosis compared to the Needle Group in lower eyelid rejuvenation treatment.

    眶周老化下睑年轻化透明质酸不同注射方法比较

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    面部严重瘢痕挛缩患者行自体组织全面重建术的多学科护理1例

    沈鸣雁江志荦劳玲娣何芝易...
    77-78页
    查看更多>>摘要：树兰(杭州)医院收治1例烧伤后13年面部严重瘢痕挛缩患者，开展自体组织全面重建术，历时29个月。护理团队针对患者病情，多学科协作分期落实护理措施。一期护理重点是与患者建立连接，增强患者治疗的信心，指导患者按时来院进行扩张器的注水；二期做好皮瓣危象预见性护理干预、细致落实感染护理和康复护理。随访6个月，患者恢复良好。实施多学科协作护理方案有助于提高患者的护理效果。

    烧伤瘢痕挛缩护理多学科修复外科

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    整形外科内窥镜技术三步法培训方法的探讨

    尹诗璐李比夏有辰马建勋...
    79-80页
    查看更多>>摘要：探讨整形外科内窥镜技术三步法培训的效果。2015年9月至2019年9月，北京大学第三医院成形外科采取三步法对成形外科进修医师及专科培训医师进行内窥镜技术培训，通过问卷调查60名[男33名、女27名，年龄27～43(34.1±3.8)岁]参培医师的培训效果。共收回51份有效问卷，参加培训学员平均整形外科工作年限(5.7±2.6)年。46名( 90.2%)学员表示培训能明显提升内窥镜理论知识，45名(88.2%)表示能明显提升内窥镜操作技术，47名(92.2%)表示能明显增加未来开展内窥镜整形手术的信心。有内窥镜手术经验学员培训效果评分高于无经验学员(P<0.05)。内窥镜技术三步法培训方法有助于提高整形外科医师技术，培训应合理地增加手术实际操作机会。

    整形外科内窥镜技术三步法培训

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    线粒体在皮肤光老化的研究进展

    樊力攀曾霓夏青月栾兴宝...
    81-84页
    查看更多>>摘要：外源性老化中，紫外线照射导致的皮肤老化占80%以上，称为皮肤光老化。皮肤光老化中线粒体形态和能量代谢等均有异常，通过线粒体自噬去除异常线粒体后可延缓皮肤光老化，线粒体参与了皮肤光老化有关过程。本文概述光老化皮肤中与线粒体生物事件相关的多种表现，包括线粒体的形态异常、线粒体能量代谢异常、线粒体氧化应激异常、线粒体自噬、以线粒体为靶点的抗光损伤药物。

    线粒体皮肤光老化紫外线

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    干细胞疗法用于雄激素性脱发毛发再生的研究进展

    熊佳超郭荣贾玲玲孙于林...
    84-87页
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