陈淑君 姜海燕 周珺

[摘要]目的：探讨胶原蛋白替代透明质酸注射治疗泪睑沟凹陷的效果及预后。方法：选择2015年6月-2017年6月共12例泪睑沟凹陷经透明质酸填充后发生水肿、下睑袋加重、丁达尔现象和条索状隆起等并发症的患者，通过溶解部分透明质酸后注射胶原蛋白进行修复治疗。观察术前、溶酶后、术后患者的泪睑沟凹陷改善情况、并发症的消失情况、“黑眼圈”的改变等变化。结果：注射胶原蛋白后可见透明质酸填充并发症消失，凹陷部位饱满，“黑眼圈”得到明显改善。结论：胶原蛋白注射修复透明质酸注射治疗泪睑沟凹陷后并发症是比较理想的选择，可以避免透明质酸填充引起的并发症，同时可以改善“黑眼圈”，值得临床推广。

[关键词]泪睑沟凹陷；胶原蛋白；透明质酸；黑眼圈；丁达尔现象

[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2018）06-0031-04

Abstract： Objective To investigate the effect and prognosis of collagen protein for the treatment of complications after hyaluronic acid injection in lacrimal palpebral sulcus depression patients. Methods From June 2015 to June 2017， a total of 12 patients with complications including malar edema， pouch aggravation， Tyndall effect and stripe shaped protuberance post HA injection for the treatment of lacrimal palpebral sulcus depression. Collagen protein was chosen to repair the complications after hyaluronidase dissolved part of HA. The observations on improvements of tear trough deformity， complications from HA and the “dark circles” were executed before and after the treatment. Results Collagen protein injection resulted in improvement on the complications such as malar edema、tyndall effect and tear trough deformity. We found significant improvement on the “dark circles” beyond expectation. All patients reported cosmetic satisfaction. No severe adverse event was recorded. Conclusion This case series confirmed the effective use of collagen protein in correction for the complication post tear trough HA injection. It resulted in excellent patient satisfaction， minimal complications， and amelioration on the “dark circles”. It is worthy spreading.

Key words： depressions of lacrimal palpebral sulcus； collagen protein； hyaluronic acid（HA）； dark circle； tyndall effect

目前淚睑沟矫治最常用的方法是使用可吸收降解的皮肤填充剂注射治疗，使用最广泛的填充剂是透明质酸，其是一种安全有效的吸水性填充材料，具有损伤小，易于塑形，副作用少，治疗泪睑沟效果理想等优势。但临床应用过程中发现注射透明质酸的患者术后1个月或数月后注射部位可出现水肿，下睑袋加重，甚至产生丁达尔现象（Tyndall effect）引起的淡蓝色印记，以及微笑时由于肌肉的挤压产生条索状隆起等现象。而胶原蛋白填充剂作为一种新型的抗衰老美容填充材料，能促进自身合成胶原蛋白，也能起到矫形作用[1]，逐渐被应用于填充皱纹和容量缺损等治疗中。……