目的：

探讨基质血管成分胶（stromal vascular fraction-gel, SVF-gel）填充治疗面部凹陷性瘢痕的临床疗效、患者满意度、安全性以及相关影响因素。

方法：

本研究是一项单中心回顾性研究。我们回访了采用SVF-gel填充治疗面部凹陷性瘢痕的患者，收集患者面部凹陷性瘢痕形成时间、形成原因、类型等信息。为了评价治疗效果，在术前和术后随访时拍摄照片，由2名未参与研究的主治医生通过照片对所有患者术前和术后凹陷性瘢痕进行瘢痕总体评分，对痤疮瘢痕患者术前和术后凹陷性瘢痕采用痤疮瘢痕临床评估量表（Échelle d'évaluation clinique des cicatrices d'acné, ECCA）进行评分。通过面部临床评估系列问卷（Facial Clinical Assessment Questionnaire, FACE-Q）评估患者对手术结果满意度和决定满意度，并记录填充区及吸脂区相关并发症。采用单因素和多因素分析探讨瘢痕总体评分及患者手术和决定满意度的独立影响因素。

结果：

本研究共纳入90例患者，其中男32例、女58例，年龄32.17±6.09岁，术前瘢痕总体评分为5.04±2.00分，术后瘢痕总体评分为2.91±1.64分，两者之间的差异有统计学意义（t=16.35，p<0.001）。术前ECCA评分为150.07±14.47分，术后ECCA评分下降至120.55±13.73分，手术前后评分之间的差异具有统计学意义（t=35.88，p<0.001）。69位患者对手术结果感到满意（手术满意度评分≥60），满意率76.7%；71位患者对决定感到满意（决定满意度评分≥60），满意率为78.9%。填充区的主要并发症为发红，发生率为82%（74/90），持续时间为2.3±0.6周。吸脂区的主要并发症为瘢痕增生，发生率为4%（4/90）。单因素和多因素分析结果提示：瘢痕形成原因是治疗效果的独立影响因素，痤疮型凹陷性瘢痕患者瘢痕总体评分的改善值大于非痤疮型凹陷性瘢痕患者。而瘢痕凹陷类型、填充次数和瘢痕形成时间是患者满意度的独立影响因素，当患者瘢痕凹陷类型为碾压型、填充次数更多、瘢痕形成时间更短时，患者满意度显著提高。

结论：SVF-gel填充治疗面部凹陷性瘢痕疗效明显，患者满意度较高，是一种安全有效的治疗方法。

Objective: To investigate the clinical efficacy, patient satisfaction, safety, and influencing factors of stromal vascular fraction-gel (SVF-gel) injection in the treatment of facial depressed scars. Method: This study is a single-center retrospective study. We conducted follow-up visits with patients who had undergone SVF-gel injections for the treatment of facial depressed scars, collecting information on the time of scar formation, causes, and scar types. To evaluate treatment outcomes, standardized photographs were taken during both preoperative and postoperative follow-up visits. Two attending physicians, who were not involved in the study, independently assessed the overall scar scores before and after treatment based on these photographs. For patients with acne scars, the Échelle d'évaluation clinique des cicatrices d'acné (ECCA) scale was used to score the atrophic scars pre- and post-treatment. Patient satisfaction with both the surgical outcomes and their decision to undergo treatment was assessed using the Facial Clinical Assessment Questionnaire (FACE-Q) questionnaire series. Additionally, complications related to both the injection area and liposuction area were recorded. Univariate and multivariate analyses were conducted to identify independent factors associated with changes in overall scar scores as well as patient satisfaction with the surgery and treatment decision. Results: A total of 90 patients were included in this study, comprising 32 males and 58 females, with a mean age of 32.17±6.09 years. The preoperative overall scar score was 5.04±2.00, which significantly decreased to 2.91±1.64 after treatment (t=16.35, p<0.001). The mean preoperative ECCA score was 150.07±14.47, which decreased to 120.55±13.73 postoperatively, with a statistically significant difference between the two time points (t=35.88, p<0.001). A total of 69 patients (76.7%) were satisfied with the surgical outcome (satisfaction score≥60), and 71 patients (78.9%) were satisfied with their decision to undergo treatment (decision satisfaction score≥60). The most common complication in the injection area was erythema, which occurred in 82% of patients (74/90), with an average duration of 2.3±0.6 weeks. In the liposuction area, the main complication was hypertrophic scarring, which occurred in 4% of patients (4/90). Results from univariate and multivariate analyses indicated that the cause of scar formation was an independent factor affecting treatment efficacy. Patients with acne-related atrophic scars experienced a greater improvement in overall scar scores compared to those with non-acne-related scars. Additionally, the type of scar depression, number of injection sessions, and duration of scar formation were identified as independent factors influencing patient satisfaction. Patients with rolling-type scars, who received more injection sessions, and had a shorter duration since scar formation reported significantly higher satisfaction. Conclusion: SVF-gel filler is a safe and effective treatment for facial depressed scars, with obvious efficacy and high patient satisfaction.