目的：探讨腹壁老化的临床特点、诊断分型的评估方法及治疗策略

方法：回顾性分析2014 年1月至2018年12月间，北京协和医学院整形外科医院的260例由李发成教授主刀进行腹壁年轻化手术治疗的腹壁老化患者的临床资料及术后随访情况，广泛查阅国内外已发表的相关文献进行分析和总结。

结果：260例患者中，年龄为23-63岁，平均年龄37±6.8岁，24名男性，236名女性。其中行了腹部负压脂肪抽吸术(suction-assisted liposuction ,SAL)患者115例，腹部脂肪抽吸联合射频溶脂术（Radiofrequency-assisted liposuction，RFAL)）48例，小腹壁整形术36例，小腹壁整形术联合上腹部RFAL32例，吸脂腹壁整形术29例。260例均手术顺利，5例患者术后出现并发症。129例患者随访资料完整。根据术后效果评分，62例单纯脂肪抽吸术，56例效果满意，6例为良好。19例RAFL，18效果为满意，1例效果为良好。20例为小腹壁整形术，15例效果为满意，5例效果为良好。15例小腹壁整形术联合上腹部RFAL，14例效果为满意，1例为良好。13例为吸脂腹壁整形术，10例效果为满意，2例为良好，1例为一般。

结论：SAL、RAFL、小腹壁整形术和吸脂腹壁整形术是腹壁年轻化分级治疗的治疗手段。手术方式根据患者情况灵活选择和组合，本研究在Matarasso老化分型评估和手术方案选择方法的基础上结合临床经验总结出腹壁年轻化分级治疗策略。吸脂腹壁整形术可认为是有效安全的治疗方法，术前病人的选择和手术操作均是避免术后并发症的重要方面，术后需进行严密监测、准确判断病情、及时处理并发症。

ive: to investigate the clinical characteristics, diagnostic typing estimation and treatment strategy of abdominal wall aging.

methods: the clinical data postoperative follow-up of 260 patients of abdominal wall aging treated by professor lifacheng in plastic surgery hospital of peking union medical college from january 2014 to december 2018 were retrospectively analyzed, and literatures were extensively reviewed for analysis and summary.

results: there are 24 males and 236 females among the 260 patients, at age from 23 to 63 years old, with an average age of 37±6.8 years old. 115patients underwent only abdominal suction-assisted liposuction (sal), 48 patients underwent abdominal sal combined with radiofrequency-assisted liposuction (rfal), 36 patients underwent mini abdominoplasty, 32 patients underwent mini abdominoplasty combined with epigastric rfal, 29 patients underwent lipoabdominoplasty. all the 260 patients had successful operation, with 5 patients had postoperative complications after abdominoplasty. 129 patients with complete follow-up data. of 62 patients who received sal, 56 patients have great postoperative effects and 6 patients have good postoperative effects. of 19 patients underwent sal and rfal , 18 patients have great postoperative effects and 1 patients have good outcomes.20 case of mini abdominoplasty, effects of 15 are great and 5 cases are good. 15 cases of mini abdominoplasty joint epigastric rfal, 14 case as the effect is great, and the other one is good. 13 cases of lipoabdominoplasty, the effects of 10 cases are great, 2 cases are good and 1case is not bad.

conclusion：sal, rfal,mini abdominoplasty and lipoabdominoplasty are methods for the treatment for abdominal rejuvenation. according to the patient's situation, these surgical methods can be flexibly selected and combined. in this study, based on matarasso's evaluation of abdominal aging types and strategies of surgical scheme selection, combined with clinical experience, graded treatment strategies for abdominal wall rejuvenation have been summarized. lipoabdominoplasty is an effective and safe treatment, preoperative patient selection and surgical methods are important to avoid postoperative complications.