自体成纤维细胞移植充填面部凹陷的初步临床观察

摘要

Objective To observe the effect and safety of autologous cultured skin fibroblasts transplantation for treating depressed facial skin defects.Methods A total of 19 patients were treated from Jan,2010 to Oct,2010.Autologous skin fibroblasts were separated from postauricular skin biopsy or resected skin tissue in other surgeries such as blepharoplasty.They were cultured and expanded with exclusive method.Cells (2 × 107/ml) within three passages were injected intradermally at the site of skin depression three times at one-month interval.Adverse events were observed and recorded.Clinical effects were evaluated and graded by two unrelated physicians before and 6 months after the first injection.Results Cells from 16 patients were successfully cultured at the first time.The other 3 patients underwent a second harvest.A total amount of 6 × 108 cells could be reached within three passages in 45 days.16 out of 19 patients accomplished the whole course of this study.Minor adverse events were observed in two patients including small ulcer caused by over injection in one patient and slightly redness and swelling in the other.The redness disappeared after a week without any treatment.No serious complications were observed.Significant difference was noticed between the scores obtained before and after the treatment.Conclusions From this study,neither serious complications nor excessive cell proliferation or scar formation was found after cell injection.The effect of using autologous fibroblast transplantation was obvious and long-lasting,which provides a new choice for the treatment of depressed facial skin defects.%目的 观察自体成纤维细胞移植治疗面部痤疮、瘢痕等软组织凹陷的临床安全性和有效性.方法 2010年1月至11月,通过自体成纤维细胞移植,对19例患者进行面部软组织凹陷治疗.皮肤标本选用耳后皮肤或其他手术中切除的皮肤组织,利用特殊的培养方法体外培养扩增自体成纤维细胞.选用3代以内、密度为2×107/ml细胞悬液,注射于软组织缺损凹陷处,连续注射3次,间隔时间1个月.由独立医生依据治疗前和治疗终止后6个月照片,对治疗效果进行评估打分.结果 19例患者中,首次细胞培养成功为16例,45 d3代以内细胞可达约6×108数量级.共18人37处缺损部位完成治疗.注射治疗过程发生1例细胞注射过多,1例红肿,无全身不良反应.9处缺损达到轻度改善,22处中度改善,6处明显改善.结论 应用自体成纤维细胞移植治疗面部浅表凹陷,未发现严重并发症及细胞过度增生、瘢痕形成等现象；其临床效果随着时间延长逐渐明显,并可以长期维持,为临床治疗面部细小凹陷提供了新的选择.