例聚丙烯酰胺水凝胶注射充填术后遗症临床表现及处理.doc

39例聚丙烯酰胺水凝胶注射充填术后遗症临床表现及处理 　　作者：于扬 作者单位：新疆医科大学第一附属医院烧伤整形外科， 新疆 乌鲁木齐 830011 　　【摘要】 目的：分析接受聚丙烯酰胺水凝胶(PAAH)注射充填后遗症的临床表现，并探讨临床处理对策。 方法：对2005年11月至2006年12月我院就诊的院外接受PAAH注射充填39例患者的临床资料进行回顾性分析，分析后遗症的临床表现，根据注射部位不同行PAAH取出术，探讨合理的临床处理对策。 结果：39例接受PAAH注射充填术者，注射充填部位出现弥漫性或孤立性硬结12例(30.8%)，疼痛不适12例(30.8%)，PAAH注射后移位、变形8例(20.5%)，无明显的临床症状但有心理异常者6例(15.4%)，注射充填物表面皮肤红、肿、痒、痛1例(2.6%)。经临床手术和非手术治疗后患者获较满意疗效。 结论：对接受PAAH注射充填的患者，先排除局部良性、恶性肿瘤;应详细进行临床相关检查，明确注射PAAH的量和层次;必要时施行外科手术治疗;原则上手术取出PAAH的同时不置入其它安全的充填物。 　　【关键词】 聚丙烯酰胺水凝胶 充填术 后遗症 　　The clinical manifestations and procedures of sequela of 39 examples with plombage and injections of polyacrylamide hydrogel (PAAH) 　　YU Yang, MA Shao-lin, DONG Xiang-lin, et al 　　(Department of the Burn and Plastic, First Affiliated Hospital, Xinjiang Medical University,Urumqi, 830011, China) 　　Abstract： Objective： To analyze the clinical manifestations of the sequela of post-injection and plombage of PAAH in order to find a suitable treatment of the sequela of post-injection and plombage of PAAH. Methods： We gathered, summarized and analysized the clinical data of 39 patients who had been got injection and plombage of PAAH in our hospital in order to analyze the manifestations of sequela of post-injection, according to different injecting-point to find out reasonable strategy of clinical procedures. Results： The manifestations were that 12 patients diffuse or local nodes in 12 cases, local pain in 12, shifting in 8, 6 mental abnormality in 6, and 1 patient’s skin above obturator feel pain, swelling and hot. All patients had got satisfying effect after clinical operation and non-operation treatment. Conclusions： We must get rid of the possibility of local benign or malignant tumor of those patients, and chose imaging examination in order to identify quantities and layers of injected PAAH in details. We suggested those patients who had psychologic obstacle to have psychological treatment. If it’s necessary, we should take out PAAH by surgical intervention. In principle, w