Duncan Diane, Rubin J Peter, Golitz Loren, Badylak Stephen, Kesel Lynne, Freund John, Duncan Danielle
Private Practice, Ft. Collins, CO, USA.
Clin Plast Surg. 2009 Apr;36(2):195-209, v-vi; discussion 211-3. doi: 10.1016/j.cps.2008.11.001.
The unusual evolution of the practice of injection lipolysis has generated doubt regarding its safety and efficacy among many physicians. During the early years of this decade, mesotherapy was practiced by a few physicians, but the practice was not widespread. Paramedical practitioners and business developers saw the market potential for nonsurgical fat reduction, and the practice of injection lipolysis was packaged and sold before the mechanism of action was understood. Because of the early lack of scientific research and understanding of the limitations of injection lipolysis, many unsuitable patients were treated with this modality. To better understand the way injection lipolysis works, the inclusion and exclusion criteria for patients desiring treatment, and an accurate clinical evaluation format for potential treatment regions, a series of scientific studies was performed in 2007 and early 2008. These studies included a serial histopathology evaluation of treated patients over time, a stem cell study performed with the McGowan Research Institute in Pittsburgh, an animal study performed in conjunction with the Colorado State University veterinary school, and a prospective multicenter clinical trial using injection lipolysis in the back roll region. The purpose of these studies was to determine the way injection lipolysis works, how modifications of the formula and technique change the outcome, the role of each constituent component of various formulas, and the degree of fat reduction and skin retraction that is attainable with these treatments. The influence of depth of injection, distance between injection points, volume of injection, and ratios of constituent components was studied. The degree of topographic contour correction and the amount of volume reduction were evaluated. Following a review of these recent studies, an updated recommendation for the clinical practice of injection lipolysis was formulated.
注射溶脂术的异常发展引发了许多医生对其安全性和有效性的怀疑。在本世纪头几年，只有少数医生开展中胚层疗法，但该疗法并未广泛应用。辅助医疗从业者和商业开发者看到了非手术减脂的市场潜力，在尚未了解注射溶脂术的作用机制之前，就将其包装并推向市场。由于早期缺乏科学研究以及对注射溶脂术局限性的认识，许多不适合的患者接受了这种治疗方式。为了更好地了解注射溶脂术的作用方式、适合治疗的患者的纳入和排除标准以及对潜在治疗区域进行准确临床评估的方法，2007年和2008年初开展了一系列科学研究。这些研究包括对接受治疗的患者进行长期连续组织病理学评估、与匹兹堡的麦高恩研究所合作进行的干细胞研究、与科罗拉多州立大学兽医学院联合进行的动物研究，以及在背部赘肉区域使用注射溶脂术的前瞻性多中心临床试验。这些研究的目的是确定注射溶脂术的作用方式、配方和技术的改变如何影响治疗效果、各种配方中每种成分的作用，以及这些治疗所能达到的脂肪减少和皮肤回缩程度。研究了注射深度、注射点间距、注射量和成分比例的影响。评估了局部轮廓矫正的程度和体积减少量。在对这些最新研究进行综述之后，制定了注射溶脂术临床应用的最新建议。
