韩稷钰 李宁 刘莹 肖志波

[摘要]聚丙烯酰胺水凝胶注射隆乳术后可出现多种并发症，而且多种并发症往往共存。目前，临床主要处理方法有穿刺或小切口抽吸法，手术切开取出注射物，内窥镜微创取出法等。注射物取出后对乳房形态修复的方式主要有一期和二期乳房硅胶假体置入两种方式。本文旨在分析比较聚丙烯酰胺水凝胶注射隆乳术后各种处理方法的优劣，重新考量现存方法的合理性和不足之处。从循证医学角度对现存的多种手术方法和乳房形态修复方法进行评价和综述。

[关键词]聚丙烯酰胺水凝胶;注射隆乳;并发症;乳房形态修复

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）06-0188-02

Rethinking the Treatment of Breast Injury after Augmentation Mammoplasty with Polyacrylamide Hydrogel Injection

HAN Ji-yu， LI Ning， LIU Ying， XIAO Zhi-bo

（Department of Plastic and Cosmetic Surgery， the Second Affiliated Hospital of Harbin Medical University，Harbin 150086，Heilongjiang， China）

Abstract：There are many complications after polyacrylamide hydrogel injection for breast augmentation， and a variety of complications often coexist.At present，the main clinical treatment methods include puncture or small incision aspiration， surgical incision to remove the hydrogel， and endoscopic minimally invasive surgery. There are two main ways to repair the shape of breast after the injection is removed： one-stage and two-stage breast silicone prosthesis implantation. The purpose of this paper is to analyze and compare the advantages and disadvantages of various treatment methods after augmentation mammoplasty with polyacrylamide hydrogel injection， and to reconsider the rationality and shortcomings of the existing methods. From the perspective of evidence-based medicine， this paper evaluates and reviews the existing methods of surgery and breast morphological repair.

Key words：polyacrylamide hydrogel; breast augmentation with injection; complications; breast shape repair

聚丙烯酰胺水凝膠（Polyacrylamide hydrogel，PAHG）曾是广大求美者喜爱的乳房软组织填充物，1997年从乌克兰引入国内，之后也出现了国产的PAHG，PAHG注射隆乳以操作简单、创伤小及见效快的优点迅速风靡全国。但随着时间推移各种并发症不断出现，CFDA遂于2006年4月30日，禁止了该材料的生产使用。到目前为止PAHG已经禁用十几年之久，然而其引起的乳房后续损害仍在临床上多见，现对治疗PAHG隆乳并发症的治疗方法进行评价和综述。

1  PAHG注射隆乳后的取出方法及优劣

1.1 穿刺抽吸方法取出乳房注射物：采用乳房下皱襞小切口挤出注射物，反复冲洗抽吸的治疗方式曾被广泛使用，然而现有证据表明盲视下的抽吸不能将注射物完全去除，术后残留率和复发率均较高[1]。盲视下操作会导致注射物层次更加混乱，使后续手术难度加大。……