玻璃酸酶及高压氧对玻尿酸隆鼻致血管栓塞的疗效性研究

发布时间：2018-06-03 02:42

本文选题：玻尿酸 + 隆鼻　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]1.探讨玻尿酸隆鼻致血管栓塞后玻璃酸酶的使用时间与治疗效果的关系;2.探讨高压氧治疗的应用与玻尿酸隆鼻致血管栓塞治疗效果的关系。[方法]本研究包括临床部分和基础部分两部分,第一部分为临床部分,选用2015年9月至2016年11月收住于昆明医科大学第二附属医院整形外科住院部以鼻部感染为主要诊断、玻尿酸隆鼻后鼻部不适为主诉的8例患者为研究对象。对每位患者进行玻璃酸酶局部注射、高压氧及支持治疗。第二部分为基础部分,2016年12月至2017年2月,选用成年雌性伊拉兔24只,兔耳共48只,建立兔耳耳郭中动脉玻尿酸栓塞模型。兔耳分组,1组为对照组;2、3、4、5组分别为兔耳耳郭中动脉玻尿酸栓塞模型建立后4h、8h、24h和48h注射玻璃酸酶治疗组;6组为高压氧治疗组。于兔耳耳郭中动脉玻尿酸栓塞模型建立后第1天、第7天和第14天进行兔耳影像、背侧温度和末端血氧饱和度的采集,于第14天进行兔耳坏死组织面积和组织学标本采集,将数据进行统计分析。[结果]临床部分,8例玻尿酸隆鼻致血管栓塞患者痊愈出院,部分患者遗留瘢痕。基础部分,兔耳耳郭中动脉玻尿酸栓塞模型建立后第14天各实验组的兔耳坏死面积具有统计学差异(P0. 05);所有实验组的兔耳坏死面积具有增长趋势;4组与5组兔耳坏死面积差异无统计学意义;1组与其他5组兔耳坏死面积均有统计学差异(P0. 05)。[结论]玻尿酸隆鼻致血管栓塞发病48小时之内予以玻璃酸酶局部注射可取得明显疗效,越早使用疗效越好。高压氧治疗玻尿酸隆鼻致血管栓塞的效果可靠,临床可作为常规辅助治疗方法之一。
[Abstract]:[objective] 1. To investigate the relationship between the time of hyaluronidase use and the therapeutic effect after embolization induced by hyaluronic acid rhinoplasty. To explore the relationship between the application of hyperbaric oxygen therapy and the effect of vascular embolization induced by hyaluronic acid augmentation nose. [methods] this study includes two parts: clinical part and basic part. The first part is clinical part. The inpatient department of plastic surgery in the second affiliated Hospital of Kunming Medical University from September 2015 to November 2016 was selected as the main diagnosis of nasal infection. Eight patients with nasal discomfort caused by hyaluronic acid augmentation rhinoplasty were studied. Each patient was given local hyaluronidase injection, hyperbaric oxygen and supportive therapy. The second part is the basic part. From December 2016 to February 2017, 24 adult female rabbits and 48 rabbit ears were selected to establish the model of hyaluronic acid embolization in the middle auricle of rabbits. Rabbit ears were divided into two groups: control group (n = 5): the middle auricle artery hyaluronic acid embolization model was established at 4 h, 8 h, 24 h and 48 h after injection of hyaluronidase respectively, the 6 groups were treated with hyperbaric oxygen. On day 1, day 7 and day 14 after the establishment of the model of hyaluronic acid embolization in the middle ear of rabbit ear, the images of rabbit ear were collected, the temperature of the dorsal side and the blood oxygen saturation at the end of the ear were collected, and the necrotic tissue area and histological specimens of the ear were collected on the 14th day. Make statistical analysis of the data. Results: 8 patients with vascular embolism caused by hyaluronic acid augmentation rhinoplasty were cured and some patients left scar. On the 14th day after the establishment of hyaluronic acid embolization model of the middle ear artery of rabbit ear, the necrotic area of each experimental group had statistical difference (P 0. 0). There was no significant difference in necrosis area between group 4 and group 5. There was no significant difference in necrosis area between group 1 and other 5 groups (P 0. 0). 05. [conclusion] Local injection of hyaluronidase is effective within 48 hours of embolism caused by hyaluronic acid augmentation rhinoplasty, and the earlier it is used, the better the effect is. Hyperbaric oxygen (HBO) is an effective and reliable method in treating vascular embolism caused by hyaluronic acid augmentation rhinoplasty and can be used as a routine adjuvant therapy.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R62

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