低位小切口直视包膜入路处理聚丙烯酰胺水凝胶隆乳并发症.docVIP

低位小切口直视包膜入路处理聚丙烯酰胺水凝胶隆乳并发症[择要]目的：探讨聚丙烯酰胺水凝胶注射隆乳出现并发症后的有效清除路经和治疗方法。方法：乳房皱襞外下方设计小切口，直视下全层切开注射物最外层包膜，先挤出后冲洗，然后手指腔内探查并引导器械清除残留注射物。结果：21例患者均一次取出成功，包括11人即刻假体隆乳患者，创面一期愈合，未见并发症。结论：低位小切口直视包膜入路法具有：微创、好操作、易引流、愈合快、能较好地保护乳房形态等优点。 [关键词]聚丙烯酰胺水凝胶；低位小切口；直视包膜入路 [中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2012）01-0028-03 Surgical treatment of breast augmentation complications injected with polyacryamine hydrogel (PAHG) through a lower-sited minor incision and transcapsular route CAO Shi-hua1,ZHANG Jin-liang2,ZHOU Qi-guang3 (Korea Plastic Surgery Hospital,Anhui 230031,Hefei,China; 2.Huainan East Group Hospital; 3.U.S. Hospitals to Shaoxing) Abstract: Objective To explore an effective route and treatment approach for breast augmentation complications injected with polyacryamine hydrogel. Methods A mini incision was designed underneath low outer ruga of the breast. Under direct vision,whole layer of the capsule was dissected and injected materials of PAHG were squeezed out and then washed. With direction of fingers the cavity was explored and reminants of the materials were cleared with instruments. Results The PAHG materials were successfully removed once in 21 cases,including 11 cases of breast augmentation with prosthesis,and all the patients were primary healing without any complications. Conclusion The lower-sited minor incision and transcapsular route has advantages of mini-invasive,easy manipulation, adequate drainage,fast healing and well-preservation of breast morphology. Key words:polyacryamine hydrogel;lower-sited and minor incision;procedures under direct vision 聚丙烯酰胺水凝胶（英文缩写PAHG），国内商品名奥美定，俗称“人造脂肪”，国外最常见的同类产品称“英捷尔法勒”。国家从2006年4月30日起，已全面叫停了注射用PAHG的生产、销售和使用。多年来，关于奥美定隆乳和取出的争论和探讨从来没有停止过[1]，现阶段，仅《中国美容医学》曾刊登了一篇“建议案”文章[2]，内容虽比较丰富，但还没有一个官方正式的PAHG隆乳并发症处理的诊疗标准。现有文献报道PAHG的常规取出路径主要有：乳晕切口[3]、腋下切口[4]、乳房下皱襞切口和乳房表面破溃处入路[5]四种方法。主要通过挤、吸、刮、冲洗、剪除等手法清除充填物。我院于2005年改用乳房皱襞下外侧：低位[6]、小切口[7]、直视包膜入路及手指配合探查的方法，达到了理想的治疗效果， 现报道如下。 1 资料和方法 1.1 临床资料：2005年～2010年11月共诊治21例患者，年龄21～42岁；注射时间为