【摘要】　目的　 探讨肥胖人群减肥后体重急剧下降导致腹壁松弛行腹壁整形手术的疗效。　方法　 2003年4月-2009年10月，24例减肥后体重下降导致腹壁松弛患者中男3例，女21例，年龄28~44岁，平均36岁。其中1例合并甲状腺功能亢进，1例合并糖尿病病史；20例均通过运动、控制饮食等方式致体重下降，4例接受胃减容手术后体重下降。体重下降稳定后至腹壁整形手术时间间隔2~4年，平均2.5年；减肥前至腹壁整形手术前体重下降37~67 kg，平均下降45 kg。手术采用屈髋位，切除松弛皮肤组织，收紧腹壁及腰部松弛组织，耻骨上沿皮瓣远端去表皮后与耻骨上沿骨膜缝合固定。所有患者随访5个月~2年。　结果　 23例术后2周皮瓣完全成活，切口愈合良好，无切口感染；1例术后出现耻骨上切口约2 cm表皮裂开，换药2周后切口愈合，术后腹壁平整、对称，无皮下血肿发生。随访期间切口疤痕隐蔽，阴阜无上移，腹壁平坦、对称。　结论　 该腹壁整形手术方式效果良好，术后并发症少，值得推广。
From April 2003 to October 2009, 24 obese patients, including three males and 21 females, developed abdominal chalastodermia caused by weight loss. Their age ranged from 28 to 44 years old with an average age of 36 years. Among them, one had hyperthyroidism and one had a medical history of diabetes. Twenty patients lost weight by exercise and diet, while the other four lost weight through stomach reduction surgery. Time span from weight loss to abdominal plastic surgery was two to four years, averaging at 2.5 years. During the time from before weight loss until the surgery, weight loss ranged from 37-67 kg, averaging at 45 kg. The surgery adopted the position of bending hip. The loose skin was removed; abdominal wall and loose waist tissues were tightened; and the far end of flap without skin along the upper edge of pubis was sutured with the periosteum. All patients were followed up for a time ranged from five months to two years.　Results　 Flaps survived within two weeks after the surgery, incision healed perfectly, and no infection occurred to the incision for all the patients except in one case, there was a 2 cm of skin fissure in the upper incision which was cured after two weeks of dressing. After the surgery, the abdominal wall was flat and symmetrical without subcutaneous hematoma. During the follow-up, scars were well hidden, mons pubis was not shifted upward, and the abdominal wall was flat and symmetrical.　Conclusion　 The abdominal wall plastic surgery has a good clinical outcome with few complications, which is worth being popularized.

Citation： LU Yuangang,CEN Ying. Abdominoplasty for Patients with Obesity after Weight Loss. West China Medical Journal, 2011, 26(4): 540-543. doi: Copy