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实验性诱导脂肪栓塞中血管内脂质的移位：一项初步研究。

Transposition of intravascular lipid in experimentally induced fat embolism: a preliminary study.

作者信息

Hwang So-Min, Lee Jong-Seo, Kim Hong-Il, Jung Yong-Hui, Kim Hyung-Do

机构信息

Aesthetic, Plastic and Reconstructive Surgery Center, Good Moonhwa Hospital, Busan, Korea.

出版信息

Arch Plast Surg. 2014 Jul;41(4):325-9. doi: 10.5999/aps.2014.41.4.325. Epub 2014 Jul 15.

DOI:10.5999/aps.2014.41.4.325
PMID:25075352
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4113689/
Abstract

BACKGROUND

Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles.

METHODS

A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain.

RESULTS

Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area.

CONCLUSIONS

Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.

摘要

背景

抽脂术是一种通过物理力量减少皮下脂肪体积的手术。细胞内储存脂肪由甘油三酯组成，而循环中的脂肪颗粒则以与载体蛋白结合的胆固醇或甘油三酯形式存在。脂肪颗粒在生理上被破坏后，其储存形式不可避免地会进入循环系统。然而，迄今为止，尚无研究阐明游离脂肪颗粒亚临床阶段后发生的脂肪栓塞的致命特征。

方法

将人抽脂物与生理盐水的混合物（1:100，0.2 mL）注入平均体重为200 g的大鼠颈外静脉。在术后72小时内，每隔12小时检查一次肺和肾的活检标本。通过油红O染色在组织学上确认注入的游离脂肪颗粒的沉积位置和转运情况。

结果

与先前的报道不一致，游离脂肪颗粒从血管内空间转运至实质。输注后24小时，油红O染色证实血管腔内有游离脂肪颗粒沉积。输注后72小时，游离脂肪颗粒紧密聚集在血管周围区域附近的实质空间内。

结论

许多外科医生都意识到游离脂肪颗粒的致命后果和未被发现的病理生理机制。我们的结果表明，通过生理过程降解的脂肪储存形式的游离脂肪颗粒可能通过直接转运机制和吞噬摄取被清除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/f179e69a57de/aps-41-325-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/65908841f24d/aps-41-325-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/4cf3d229dffa/aps-41-325-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/c2a4d7e571c0/aps-41-325-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/c2097bf5dc0a/aps-41-325-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/fddc8d8f577d/aps-41-325-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/f179e69a57de/aps-41-325-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/65908841f24d/aps-41-325-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/4cf3d229dffa/aps-41-325-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/c2a4d7e571c0/aps-41-325-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/c2097bf5dc0a/aps-41-325-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/fddc8d8f577d/aps-41-325-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f89/4113689/f179e69a57de/aps-41-325-g006.jpg

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