聚丙烯酰胺水凝胶注射美容的临床与组织学评估

Clinical and histological evaluation of the injectable hydrophilic polyacrylamide gel

目的 探讨聚丙烯酰胺水凝胶注射后并发症的临床与组织学特点。方法 对 1998年至 2 0 0 3年接诊的 5 2例在外院注射了聚丙烯酰胺水凝胶 ,并引起并发症患者的临床资料进行了总结与组织学研究。为了便于比较 ,另选 12例 1988年～ 1994年期间接受液态硅胶注射的患者取出的组织病理切片与之对照研究。结果 聚丙烯酰胺水凝胶注射后并发症以局部硬结最多见 ,而且多发生在注射后 1～ 2年左右时间里。人体组织对注射的聚丙烯酰胺水凝胶的反应为多核异物巨细胞增生 ,并形成肉芽肿。与液态硅胶比较 ,注射的聚丙烯酰胺水凝胶引起组织的淋巴细胞反应弱 ,材料周围的纤维包膜较薄。机体内长期存留的聚丙烯酰胺水凝胶可能会引起局部组织变性反应。结论 聚丙烯酰胺水凝胶作为软组织填充剂的安全性需要进一步研究。

Objective To investigate the clinical and histological features of the complications after hydrophilic polyacrylamide gel injection. Methods Fifty-two patients were included in this study,who had undergone hydrophilic polyacrylamide gel injection in other units from 1998 to 2003 and later came to our department for removal of the injected gel. The tissue samples taken from each cyst were sectioned and stained with hematoxylin and eosin. The sections were investigated and analyzed under light microcopy. The tissue sections of 12 patients who had ever received liquid silicone injection from 1988 to 1994 were used as the control group. The difference in histological features was assessed. Results The inflammatory reaction of the hydrophilic polyacrylamide gel was characterized by an increased number of foreign-body giant cells. The mild lymphocyte infiltration was shown in the slides of hydrophilic polyacrylamide gel. On the contrary,there were much more clusters or lymphocyte infiltration in the slides of liquid silicone. The differences between the hydrophilic polyacrylamide gel and liquid silicone were significant in terms of thickness of the fibrous capsule. Conclusions The security of hydrophilic polyacrylamide gel injection for soft tissue augmentation is in doubt ;