奥美定隆乳注射患者术后取出的手术方式分析
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摘要
目的:探讨奥美定隆乳注射患者术后取出的手术方式。方法:对我科收治的奥美定注射患者,根据其临床表现、B超和MRI检查分成包膜硬结型、散在团块型、液态游走型及混合型,对不同类型的患者采取不同的手术方式。比较其愈合时间、术后并发症及复发情况。结果:乳腔镜手术在伤口愈合时间上显著短于乳晕切口包块取出术。液态游走型或混合型患者行乳腔镜下包块取出术,术后伤口感染、疾病复发率显著高于乳腺切除组。结论:包膜硬结型、散在团块型可行乳腔镜包块取出术、乳晕切口包块取出术或乳腺部分切除术,以尽量保留乳腺的完整,液态游走型或混合型应行乳腺全切术以彻底根治。
Objective: To explore the surgical method for the removal of Amazingel after augmentation mammoplasty.Methods: According to the clinical manifestations,B-mode ultrasonography and MRI,the patients admitted to our department were divided into envelope sclerosis type,scattered mass type,liquid migration type and mixed type. Different surgical methods were adopted for different types of patients. The healing time,postoperative complications and recurrence were compared. Results: The wound healing time of mastoscopic mastectomy was significantly shorter than that of mass removal via areola of breast incision. The rates of wound infection and disease recurrence after mastoscopic mastectomy in patients with liquid migration or mixed type undergoing mastoscopic mass removal were significantly higher than those in mastectomy group. Conclusion: Envelope sclerosis type and scattered mass type are feasible for mastoscopic mass removal,mass removal via areola of breast incision or partial mastectomy in order to preserve the integrity of the breast as far as possible. Liquid migration type or mixed type should be treated with total mastectomy for radical cure.
Objective: To explore the surgical method for the removal of Amazingel after augmentation mammoplasty.Methods: According to the clinical manifestations,B-mode ultrasonography and MRI,the patients admitted to our department were divided into envelope sclerosis type,scattered mass type,liquid migration type and mixed type. Different surgical methods were adopted for different types of patients. The healing time,postoperative complications and recurrence were compared. Results: The wound healing time of mastoscopic mastectomy was significantly shorter than that of mass removal via areola of breast incision. The rates of wound infection and disease recurrence after mastoscopic mastectomy in patients with liquid migration or mixed type undergoing mastoscopic mass removal were significantly higher than those in mastectomy group. Conclusion: Envelope sclerosis type and scattered mass type are feasible for mastoscopic mass removal,mass removal via areola of breast incision or partial mastectomy in order to preserve the integrity of the breast as far as possible. Liquid migration type or mixed type should be treated with total mastectomy for radical cure.
引文
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[9]王晓,仇树林,王书霞.医用聚丙烯酰胺水凝胶对人体成纤维细胞影响的电镜观察[J].中华医学美学美容杂志,2010,16(4):256-258.
[10]高俊明,冷奎仿,盛飞,等.包膜外聚丙烯酰胺水凝胶注射隆乳材料取出同期双平面假体隆乳术[J].中国美容医学,2010(11):1588-1590.
[2]梁惟苓,马瑶,梁一国.聚丙烯酰胺水凝胶注射丰胸后并发乳腺癌1例报告[J].吉林医学,2012,33(14):3130.
[3]王毓璈,杨天鹏,应奇才,等.聚丙烯酰胺水凝胶注入兔体的免疫效应研究[J].中华医学美学美容杂志,2002,8(3):146-148.
[4]ZARINI E,SUPINO R,PRATESI G,et al. Biocompatibility and tissue interactions of a new filler material for medical use[J]. Plast Reconst Surg,2008,1(14):934.
[5]艾小红,明佳,范林军.腔镜下隆乳剂取出术后反复感染治疗的个案报道[J].中华乳腺病杂志:电子版,2011,5(4):503-507.
[6]孙家明,袁泉.郭科等. MRI三维重建在聚丙烯酰胺水凝胶隆乳术后诊断中的应用[J].中华整形外科杂志,2008,2(5):371-373.
[7]曹士华,张金亮,周其光.低位小切口直视包膜入路处理聚丙烯酰胺水凝胶隆乳并发症[J].中国美容医学,2012,21(1):28-30.
[8]吴剑,姚欣敏,罗静,等.腔镜技术联合彩色多普勒超声通过不同切口方式取出聚丙烯酰胺水凝胶注射隆乳剂[J].华西医学,26(7):1046-1049.
[9]王晓,仇树林,王书霞.医用聚丙烯酰胺水凝胶对人体成纤维细胞影响的电镜观察[J].中华医学美学美容杂志,2010,16(4):256-258.
[10]高俊明,冷奎仿,盛飞,等.包膜外聚丙烯酰胺水凝胶注射隆乳材料取出同期双平面假体隆乳术[J].中国美容医学,2010(11):1588-1590.