肿胀麻醉技术在常规整形美容手术中应用探究.docVIP

肿胀麻醉技术在常规整形美容手术中应用探究[摘要]目的：探讨在隆乳、除皱、扩张器置入等手术中向剥离层次内注入肿胀液的方法及其临床意义。方法：在22例隆乳、15例扩张器置入、10例额颞部除皱术、25例巨痣切除手术中，向手术区注入适量肿胀液后再剥离，并与未注射肿胀液的28例类似的手术进行比较，分析其临床优势和意义。结果：在局部注射肿胀液的病例中，术中剥离时出血少，术后1～3天疼痛减轻，术后局部瘀血、红肿发生率都大为降低。结论：术中局部注射肿胀液能明显减轻术中出血、术后早期疼痛及减少术后局部瘀血红肿的发生率。 [关键词]肿胀液；隆乳术；除皱；皮肤软组织扩张术；巨痣切除术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）06-0810-03 Application study of local tumecent technique in aesthetic and plastic surgery operation YI Yang-yan,HU Qiong-hua,LIU Wen-ge,LIN Tao,WAN Lei,YUAN Jing-dong (Department of Aesthetic and Plastic Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China) Abstract：ObjectiveTo explore the clinical significance of injecting the tumescent fluid into the separated space in breast augmentation,lift operation, tissue expansion,giantnaevus operation. Methods In 22cases of breast augmentations by transaxillary incision，15cases tissue expansion,10 cases forehead and temporal lift operation,25 cases giant naevus operation, some tumescent fluid was injected into the incision and submuscular or subgland space，and then separatedunder general anethesia. By comparison of the 28 cases without tumescent fluid，the advantages and the clinical significances of this approach were discussed.ResultsThere were less bleeding, early allevation of pain after operation and decreased incidence of local congestion and swelling in patients with tumescent fluid.ConclusionThe tumescent fluid could reduce bleeding, early pain after operation and local congestion and swelling in the breast augmentation under general anesthesia. Key words:tumescent fluid； breast augmentation;lift operation; tissue expansion； giant naevus operation 手术的创伤及术中出血多少直接影响术后的恢复和手术的效果，轻柔的操作及彻底的止血显得尤为重要。如何减少手术的创伤及术中出血是我们每一个美容外科医师力求、也是应该做到的。我们在临床上发现局部麻醉液的超量注入能减少手术的创伤及术中出血。以往我们只在吸脂术中应用肿胀麻醉。吸脂时，在皮下注入一定量的肿胀液后，即使是大面积的抽吸患者无明显痛感，且术中出血不多。目前有很多医师在隆乳和腋臭的手术剥离时注入肿胀液，发现疼痛及出血均较以往得到了很大改善。肿胀麻醉用于其他需大面积剥离的美容外科手术是否有效，我们进行了一些比较研究。 自2003年以来，我们在22例隆乳、10例额颞部除皱术、15例扩