面部注射填充物并发症处理及疗效观察

发布时间：2018-09-15 05:10

【摘要】：目的:分析面部注射填充物填充后导致的各类型并发症的发生率,以及采用小切口探取法取出注射物的临床疗效。材料和方法:2015年3月至2017年2月因注射填充注射物出现并发症而于我院就诊寻求诊疗的患者共167例,186个部位。均曾于非医疗机构或私下甚至私自面部注射,因注射后导致并发症就诊于我院。本文分析汇总各并发症的发生率,除血栓栓塞患者外,均采用局麻下小切口探取法直接取出注射物,采用卡方检验比较鼻部及颏部注射物取出术后不放假体与同时放假体在术后并发症上的差异。结果:2015年3月至2017年2月因注射填充注射物出现并发症而于我院就诊寻求诊疗的患者共167人,186个部位。其中因注射填充后出现形态不佳就诊患者120人,139个部位。主诉鼻部形态不佳100例,其中63例行鼻注射物取出术并同期行假体隆鼻术,术后两周并发症7例(11.1%)。37例单纯行鼻注射物取出术暂时未置放假体,术后两周并发症2例(5.4%)。两组两周后并发症病例数经卡方检验,0.5p0.75,不存在统计学差异。主诉颏部形态不佳39例,其中9例行颏部注射物取出术后同期行假体隆颏术,术后两周均未发现并发症。30例单纯行颏部注射物取出术暂时未置放假体,术后两周并发症3例(10%)。两组两周后并发症病例数经卡方检验,0.25p0.5,不存在统计学差异。因局部感染就诊11例,均行面部注射物取出术,均未同期置放假体。术后两周并发症2例(18.2%)。因局部炎症反应就诊5例,均行面部注射物取出术,未同期置放假体,术后均无两周并发症。因局部隆起就诊22例,均行面部注射物取出术,其中3例鼻部同期行假体隆鼻术,术后两周并发症2例(9.1%)。因注射物迁移游走就诊7例,均行面部注射物取出术,术后并发症1例(14.3%)。因血管栓塞就诊2例,均予以PVP外用抗炎,服用扩血管药物治疗,两周后均预后良好。结论:面部注射填充物最常见的并发症为形态不佳,其次为局部隆起,局部感染,注射物迁移游走及局部炎症反应,血管栓塞的发生率最低。鼻部与颏部注射物取出术后同期行假体植入术与单纯行注射物取出术在术后两周并发症发生率上也不存在显著差异。面部小切口探取法可推荐作为处理填充注射后的各类并发症的处理方法。
[Abstract]:Objective: to analyze the incidence of various kinds of complications caused by facial injection filling and the clinical effect of small incision extraction. Materials and methods: from March 2015 to February 2017 167 patients with 186 sites were treated in our hospital because of complications caused by injection filling. They have been injected in non-medical institutions, privately or even privately, and have been treated in our hospital because of complications caused by injection. The incidence of complications was analyzed and summarized. Except for thromboembolism patients, the injection was removed directly by small incision under local anesthesia. Chi-square test was used to compare the difference of postoperative complications between non-holiday body and simultaneous holiday body after nasal and mental injection removal. Results: from March 2015 to February 2017, 167 patients (186 sites) were treated in our hospital because of complications caused by injection filling. Among them, 120 patients, 139 parts of them, had poor appearance after injection and filling. There were 100 cases of nasal malformation, of which 63 cases were treated with nasal injection removal and prosthetic augmentation rhinoplasty at the same time. Complications occurred in 7 cases (11.1%) in two weeks after operation. 37 cases had no prosthesis after nasal injection removal only, and 2 cases (5.4%) had complications two weeks after operation. There was no statistical difference between the two groups in the number of complications after two weeks after chi-square test (0.5 p 0.75). 39 cases complained of mental disfigurement, of which 9 cases were treated with prosthetic prosthesis protuberance after chin injection removal. No complications were found in all 30 cases after two weeks. The complications were 10% in 3 cases (10%) two weeks after operation, and 3 cases (10%) were complicated two weeks after operation. There was no statistical difference between the two groups in the number of complications after two weeks after chi-square test (0.25 p0.5). 11 patients with local infection were treated with facial injection removal and prosthesis was not implanted at the same time. Two weeks after operation, 2 cases (18.2%) had complications. 5 cases were treated with local inflammatory reaction, all of them were treated with facial injection removal, without simultaneous implantation of prosthesis, and no complications were found after two weeks of operation. 22 cases were treated with local protuberance, all of them were treated with facial injection removal, of which 3 cases underwent nasal prosthesis augmentation rhinoplasty simultaneously. Complications occurred in 2 cases (9.1%) two weeks after operation. 7 cases were treated by injection migration, all of them were treated with facial injection removal. The postoperative complications were 14.3% (1 / 7). Two patients with vascular embolism were treated with PVP for external use and vasodilators. The prognosis was good after two weeks. Conclusion: the most common complication of facial injection filling is poor morphology, followed by local protuberance, local infection, injection migration and local inflammatory reaction, and the lowest incidence of vascular embolism. There was no significant difference in the incidence of complications two weeks after nasal and mental injection removal with prosthesis implantation and simple injection removal. Facial small incision detection can be recommended as a management method for various complications after filling injection.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R622

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