韩铮 黄超有

【摘要】目的探讨聚丙烯酰胺水凝胶（水凝胶）乳房注射物取出同期假体置入手术的临床效果。 方法101例要求取出乳房注射物的患者，其中接受乳房注射物取出同期假体隆乳手术的58例设为实验组，只单纯接受乳房注射物取出手术的43例设为对照组，2组术前均行乳腺彩色多普勒超声检查及MRI明确注射物的分布情况，比较2组的手术时间、出血量、术后拔除伤口引流管的时间，以及术后1个月时患者对乳房外形的满意度评分。 结果实验组的手术时间较对照组长、术后引流管拔除时间较对照组短（P均<0.05），但2组术中出血量比较差异无统计学意义（P>0.05）。实验组术后的满意度评分较对照组高（P<0.001）。所有患者术后6个月常规复查MRI，结果显示双乳假体周围均未见明显的水凝胶残留。结论水凝胶乳房注射物取出同期假体置入手术的临床效果较好，患者满意度高，能避免二次手术的痛苦。

【关键词】聚丙烯酰胺水凝胶；乳房注射物；假体置入术

【Abstract】ObjectiveTo evaluate the clinical efficacy of polyacrylamide hydrogel breast injection removal and simultaneous prosthesis implantation. MethodIn total， 101 patients who required the removal of breast injection were recruited and divided into two groups. In the experimental group， 58 patients received the removal of polyacrylamide hydrogel breast injection and simultaneous prosthesis implantation， and 43 received the polyacrylamide hydrogel breast injection removal alone in the control group. Breast color Doppler ultrasound and MRI were performed before operation to identify the distribution of breast injection. The operation time， bleeding volume， duration of drainage after extubation and the degree of satisfaction of the breast appearance at postoperative 1 month were statistically compared between two groups. ResultsIn the experimental group， the operation time was significantly longer and duration of drainage after extubation was significantly shorter compared with those in the control group （both P<0.05）， whereas intraoperative bleeding volume did not significantly differ between two groups （P>0.05）. In the experimental group， the degree of satisfaction of the breast appearance was significantly higher than that in the control group （P<0.001）. At postoperative 6 months， conventional MRI revealed no evident residual polyacrylamide hydrogel surrounding the breast prosthesis. ConclusionsThe polyacrylamide hydrogel breast injections removal and simultaneous prosthesis implantation yields high clinical efficacy， enhances the degree of satisfaction and averts the pain of secondary surgery.

【Key words】Polyacrylamide hydrogel； Breast injection； Prosthesis implantation

聚丙烯酰胺水凝胶（水凝胶）乳房注射物取出术是整形美容外科门诊常见的手术之一，水凝胶于1997年由国外引入，由于其注射方法简单且利润高，作为软组织的填充材料在临床上被广泛应用。随着国产的水凝胶（奥美定）逐渐取代进口水凝胶被更多地应用于临床，因注射奥美定引起的诸多不良并发症也日益凸显，如乳房疼痛、注射物移位、乳房局部硬结生成、双侧乳房形态不对称等。鉴于此，2006年国家药品食品监督管理局全面停止了水凝胶的临床注射应用[1]。越来越多曾接受注射隆乳者担心体内水凝胶可能带来的危害，主动来整形美容外科门诊要求进行手术将其取出。在本研究中，笔者旨在探讨水凝胶乳房注射物取出同期假体置入手术方法的临床效果。……