乳房内组织瓣治疗注射隆乳术后巨大移动性瘘道的疗效分析.docVIP

乳房内组织瓣治疗注射隆乳术后巨大移动性瘘道的疗效分析 李乐▲，陈亮▲，流沙■，黄书鹏▲，李晓格▲，王珍祥▲，李世荣▲ ( 400038 重庆，▲第三军医大学西南医院整形美容科，■解放军324医院康复科) 摘要 目的: 国内使用聚丙烯酰胺水凝胶注射隆乳人数超过20万。近年来其并发症频频发生，对女性危害极大。而尤其乳房内PAAG混合物移位是一种最为严重的并发症，发生率高。目前治疗处理错误、加重损害的情况普遍，需要一种新的方法提高病人愈合有效率。方法: 本文收集2组共78例注射隆乳术后PAAG混合物移位的病人。其中39例，对材料移位至胸腹壁，采取手术清洗刮去残腔。而另39例，在相同外科消除胸腹壁腔隙后，进一步采用乳腺局部组织瓣的新设计治疗乳房内瘘道，封闭胸、腹壁的通道。结果: 术中见，PAAG在乳腺组织、腋窝、胸腹壁间隙广泛淤积，形成瘘道连通。采用组织瓣治疗的病人2周时分泌物减少的82%，病变腔隙缩小80%，而未用组织瓣的病人同期引流物减少46%、病变面积缩小45%，两者比较P值均＜0.01。4周时，对比两组愈合率，组织瓣治疗明显优于仅用外科方法。 结论: 乳房内PAAG混合物移位所形成的胸腹壁连通的慢性瘘道是造成胸腹壁内流动性包块与巨大空腔的主要原因。组织瓣可明显促进胸腹壁瘘道愈合。 关键词： 聚丙烯酰胺水凝胶；隆乳；并发症；瘘道；组织瓣 Curative Analysis to Treat the Huge Mobility Fistula after Injected Breast Augmentation by Local Tissue Flaps Le Li▲, Liang Chen▲, Sha Liu2, Shupeng Huang▲,Xiaoge LI▲,Zhenxiang Wang▲,Shirong LI▲ (▲Department of Plastic and Aesthetic Surgery, Southwest Hospital, Third Military Medical University, Chongqing,400038,China. ■The peoples liberation army 324 hospital rehabilitation, Chongqing,400000,China.) ［Abstract ］ Objective There were over 200,000 women who had been injected Polyacrylamide hydrogel (PAAG) for breast augmentation.It were reported the complications occurred frequently in recent years, and especially the PAAG mixture had moved into other positions, which was one of the most serious complications, and led great harm to women.Since current treatment on it were wrong and aggravated damage, the patient had ned a new way to improve patient healing efficiently.Methods Two groups including 78 cases were collected, who were found the PAAG mixture in breast shifted into abdominal wall. For 39 cases of them, PAAG shifted to the residual cavity in the chest and abdominal wall had been cleaned away by operation. And more, after fulfilled the same surgical elimination, the other 39 cases had been done to block the cavity between thoracic and abdominal, and closed the fistula of thoracic and abdominal wall by the new design of local breast tissue flap. Results 基金项目：国家自然科学基金面上项目（8107156