【摘要】：目的:分析面部注射填充物填充后導致的各類型并發(fā)癥的發(fā)生率,以及采用小切口探取法取出注射物的臨床療效。材料和方法:2015年3月至2017年2月因注射填充注射物出現(xiàn)并發(fā)癥而于我院就診尋求診療的患者共167例,186個部位。均曾于非醫(yī)療機構或私下甚至私自面部注射,因注射后導致并發(fā)癥就診于我院。本文分析匯總各并發(fā)癥的發(fā)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,采用卡方檢驗比較鼻部及頦部注射物取出術后不放假體與同時放假體在術后并發(fā)癥上的差異。結(jié)果:2015年3月至2017年2月因注射填充注射物出現(xiàn)并發(fā)癥而于我院就診尋求診療的患者共167人,186個部位。其中因注射填充后出現(xiàn)形態(tài)不佳就診患者120人,139個部位。主訴鼻部形態(tài)不佳100例,其中63例行鼻注射物取出術并同期行假體隆鼻術,術后兩周并發(fā)癥7例(11.1%)。37例單純行鼻注射物取出術暫時未置放假體,術后兩周并發(fā)癥2例(5.4%)。兩組兩周后并發(fā)癥病例數(shù)經(jīng)卡方檢驗,0.5p0.75,不存在統(tǒng)計學差異。主訴頦部形態(tài)不佳39例,其中9例行頦部注射物取出術后同期行假體隆頦術,術后兩周均未發(fā)現(xiàn)并發(fā)癥。30例單純行頦部注射物取出術暫時未置放假體,術后兩周并發(fā)癥3例(10%)。兩組兩周后并發(fā)癥病例數(shù)經(jīng)卡方檢驗,0.25p0.5,不存在統(tǒng)計學差異。因局部感染就診11例,均行面部注射物取出術,均未同期置放假體。術后兩周并發(fā)癥2例(18.2%)。因局部炎癥反應就診5例,均行面部注射物取出術,未同期置放假體,術后均無兩周并發(fā)癥。因局部隆起就診22例,均行面部注射物取出術,其中3例鼻部同期行假體隆鼻術,術后兩周并發(fā)癥2例(9.1%)。因注射物遷移游走就診7例,均行面部注射物取出術,術后并發(fā)癥1例(14.3%)。因血管栓塞就診2例,均予以PVP外用抗炎,服用擴血管藥物治療,兩周后均預后良好。結(jié)論:面部注射填充物最常見的并發(fā)癥為形態(tài)不佳,其次為局部隆起,局部感染,注射物遷移游走及局部炎癥反應,血管栓塞的發(fā)生率最低。鼻部與頦部注射物取出術后同期行假體植入術與單純行注射物取出術在術后兩周并發(fā)癥發(fā)生率上也不存在顯著差異。面部小切口探取法可推薦作為處理填充注射后的各類并發(fā)癥的處理方法。
[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.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R622

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