El-Ali Kamal M, Gourlay Terence
Department of Surgery, National Heart and Lung Institute, Imperial Collage School of Medicine, Hammersmith Hospital, London, United Kingdom.
Plast Reconstr Surg. 2006 Jun;117(7):2269-76. doi: 10.1097/01.prs.0000218715.58016.71.
Adverse consequences of liposuction, including those associated with fat embolism, have been reported in the literature. Fat embolism syndrome after liposuction may be underestimated because of the unspecific nature of the symptoms. The aim of this study was to determine whether there is a generic risk of the generation of intravascular fat emboli as a consequence of liposuction.
An animal study was conducted in which liposuction was performed on 10 Sprague-Dawley rats. The procedure was conducted with the animals under general anesthesia for 60 minutes, in a similar manner to that practiced clinically. Three blood samples were taken from each animal through a central line (one before liposuction and two at 30 and 60 minutes into liposuction) and examined for the presence of fat particles. The animals were then euthanized and the lungs and brain were removed for histological examination. In the control group, liposuction was not performed, but similar blood and histological samples were taken.
In the study group, stained fat particles were seen in all blood samples taken during liposuction but not in those taken before liposuction. The difference between the 30- and 60-minute samples and the preliposuction control ones was statistically significant (p < 0.001 minimum). The differences between the 30-minute and 60-minute samples were also statistically significant (p = 0.017), demonstrating that fat mobilization during liposuction is a cumulative process. Nothing of significance was seen in the blood samples of the control group. Lipid deposits were seen in the lungs of all study group animals but not in the control group. With one possible exception, no lipid deposits were confirmed in brain specimens.
The authors' experiments have demonstrated a significant risk of systemic fat mobilization and fat embolism after liposuction in the animal model. Further clinical investigation is required to evaluate the real clinical risk of this procedure from this perspective.
吸脂术的不良后果，包括与脂肪栓塞相关的后果，已在文献中有所报道。由于症状缺乏特异性，吸脂术后脂肪栓塞综合征可能被低估。本研究的目的是确定吸脂术是否会普遍产生血管内脂肪栓子的风险。
进行了一项动物研究，对10只斯普拉格-道利大鼠进行吸脂术。手术在动物全身麻醉下进行60分钟，方式与临床实践相似。通过中心静脉导管从每只动物采集三份血样（一份在吸脂术前，两份在吸脂术进行30分钟和60分钟时），检测脂肪颗粒的存在情况。然后对动物实施安乐死，取出肺和脑进行组织学检查。在对照组中，未进行吸脂术，但采集了类似的血样和组织学样本。
在研究组中，吸脂术期间采集的所有血样中均可见染色的脂肪颗粒，而吸脂术前采集的血样中未见。30分钟和60分钟样本与吸脂术前对照样本之间的差异具有统计学意义（最小p<0.001）。30分钟和60分钟样本之间的差异也具有统计学意义（p = 0.017），表明吸脂术中脂肪动员是一个累积过程。对照组血样中未见有意义的结果。所有研究组动物的肺中均可见脂质沉积，而对照组中未见。除一个可能的例外，脑标本中未证实有脂质沉积。
作者的实验表明，在动物模型中，吸脂术后存在全身脂肪动员和脂肪栓塞的显著风险。需要进一步的临床研究从这个角度评估该手术的实际临床风险。
