目的：探讨游离脂肪颗粒与软骨颗粒混合移植物及游离脂肪颗粒被覆软骨颗粒 移植物应用于鼻整形的可行性。

方法：取大耳白兔（I：动物材料组）及人（II：人材料组）的软骨与脂肪，构建 4 组移植物：混合组：游离脂肪颗粒与颗粒软骨等体积混合；被覆组:游离脂肪颗 粒被覆等体积软骨颗粒；对照组 1:双倍体积软骨颗粒；对照组 2:单倍体积软骨颗 粒。将上述 4 组移植物对称植入裸鼠背部近四肢处，在 4、8、16 周随机处死 I 组 3 只裸鼠、II 组 2 只裸鼠，取材并检测：1）移位及显形程度；2）质量与体积留存率； 3）力学特性；4）移植物及局部皮肤切片行苏木素-伊红染色。

结果：动物材料组（I）：术后 4、8、16 周，混合及被覆组移植物显形程度优于对照组；术后 4、8 周，混合及被覆组移植物移位程度优于对照组。术后 4、8、 16 周，被覆组移植物质量留存率低于对照组；术后 16 周，混合组移植物体积留存 率低于对照组。初始应变区间下两种复合移植物硬度低于对照组，混合组移植物硬 度更低且稳定性更好。术后 4、8、16 周，被覆组移植局部真皮厚度大于对照组；术 后 8、16 周，混合组真皮厚度大于对照组。人材料组(II)：术后 16 周，被覆组移植 物质量及体积留存率低于对照组。初始应变区间下两种复合移植物硬度低于对照组， 被覆组移植物硬度更低，混合组移植物稳定性更好；术后 4、8、16 周，被覆组移植 局部真皮厚度大于对照组；术后 4、8 周，混合组移植局部真皮厚度大于对照组。 结论：游离脂肪颗粒与软骨颗粒等体积混合、游离脂肪颗粒被覆等体积软骨颗粒两种复合移植物，显形与移位率低、具有增容效果、弹性理想且结构稳定、可改 善局部肤质，具有应用于鼻整形的可行性。临床实践中可通过适当增加移植量、按需补充脂肪注射等方式来获得更稳定、理想的术后效果。

Purpose: This study aims to evaluate the feasibility of two kinds of composite grafts (diced cartilage mixed with/ coated by granular fat graft) in rhinoplasty.

Method: Diced cartilage and granular fat graft were taken from the Japanese White Rabbits(I: animal material) or the patients(II: human material). Implants were made as follows: A (mixed group). Diced cartilage mixed with granular fat graft in equal volume; B (coated group). Diced cartilage was coated by granular fat graft in equal volume; C (control group 1). Diced cartilage in double volume; D (control group 2). Diced cartilage in single volume. The graft samples (n =5, 3 from Group I and 2 from Group II) were obtained in weeks 4, 8, and 16 to (1) evaluate the degree of visualization and displacement; （2) calculate retention rates; (3) test the elasticity and stability; (4) assess the histological characters by performing hematoxylin & eosin.

Results: Group I: The mixed and coated compositions show a lower degree of visualization and displacement. The mixed and coated group show lower quality retention rates in weeks 4, 8 and 16 while the mixed group show lower volume retention rates in weeks 16. The mixed group show lower hardness and more stability while both of the composite grafts are less hard than the control group. The composite grafts, especially the coated one can increase the thickness of derma. Group II: The coated group show lower quality and volume retention rates in weeks 16. The mixed group show more stability while the coated group show lower hardness. The composite grafts, especially the coated one can increase the thickness of derma. Conclusion: Composite grafts with diced cartilage and granular fat graft are feasible to be used in rhinoplasty with low deformity rates, good appearance, ideal elasticity and high stability while it can also improve the skin texture. Better postoperative results can be achieved by sufficient amount of transplantation and complementary fat injection as needed.