注射式隆乳术后哺乳期乳汁内瘘诊治剖析.docVIP

注射式隆乳术后哺乳期乳汁内瘘诊治剖析 　　[摘要]目的：总结聚丙烯酰胺水凝胶注射式隆乳术后哺乳期乳汁内瘘的诊治经验，探讨其发生机理及预防措施。方法：对6例注射式隆乳术后哺乳期发生乳汁内瘘患者的临床表现、辅助检查、治疗方法及结局进行回顾性分析。结果：注射式隆乳术后哺乳期乳汁内瘘突出表现为患乳呈进行性增大伴持续胀痛；超声检查见乳腺后间隙大片状不均匀低回声区，边界线紊乱，乳腺腺体层炎症表现不明显；治疗上主要是及时切开引流，尽量抽吸干净注射的凝胶，尽早退奶治疗。本组病例全部治愈，治愈时间为(12.9士4.4)天。结论：注射式隆乳术后哺乳期乳汁内瘘的原因可能是手术时损伤乳腺叶和输乳管，哺乳期因乳汁高压而破裂，乳汁流至乳腺后间隙引起。治疗关键是及时切开引流及抑制泌乳（退奶）治疗。有注射式隆乳术史的女性产后哺乳需慎重。 　　[关键词]聚丙烯酰胺水凝胶；注射式隆乳术；乳汁内瘘 　　[中图分类号]R655.8[文献标识码]A[文章编号]1008-6455（2007）09-1209-03 　　 　　The diagnosis and treatment of galactic fistula during lactation after breast augmentation with injection 　　LI Ning，CHEN Yan-wei，CHI Gang-yi,QIN Chun-li,LI Feng 　　（Department of Plastic and Aesthetic Surgery，the First PeoplesHospital，Nanning 530022, Guangxi，China） 　　 　　Abstract： ObjectiveTo summarize the experience in diagnosis and treatment of galactic fistula during lactation after breast augmentation with injection，and to approach the mechanism and prevention measures. MethodsSix cases of galactic fistula during lactation after breast augmentation with injection were retrospectively reviewed in clinical manifestations, auxiliary examinations, therapeutic methods and the therapeutic results.ResultsThe conspicuous appearance of galactic fistula during lactation after breast augmentation with injection is that the ailing breast progressively augment and feel durative gas pains. Sonography show a lamellar and inhomogeneous low echo with a indiscriminate sideline. Inflammation in the lacteal gland is obsolete. The therapeutic measures include: to incision and drainage in time;to clean up the hydrogel as far as possible; to prevent the secretion of galact. All cases in this group were cured in 12.9±4.4days.ConclusionThe reason of galactic fistula during lactation after breast augmentation with injection may be that: operative damage in lobe of mammary glands and canalicular ducts rrhexised by high pressure of galact during lactation, the galact affluence the blank behind the lacteal gland. The key point of curatio is to i