硅胶囊假体隆乳术并发症

Complications of augmentation mammoplasty with silicone breast implants

应用硅胶假体的隆乳术在我国普遍开展，各种并发症也屡有报道，手术医生应掌握该方面的相关知识及并发症的防治方法，以使受术者的痛苦减少到最低程度。过去的十年里在我科共施行１１５例硅胶假体隆乳术，发生并发症９例，主要包括血肿、积液、假体破裂、位置不正。血肿和积液早期都会引起局部疼痛且有并发感染的可能，应尽早引流血肿和积液。假体破裂的诊断很重要，最常用的方法是Ｂ超，但以ＭＲＩ最为准确。位置不正可通过准确的分离腔隙和有效的包扎固定得以预防。与硅胶假体隆乳术相关的自身免疫性疾病越来越引起关注，１５例硅凝胶乳房假体的受术者的免疫功能检查，ＩｇＧ，ＩｇＭ及Ｃ３增高提示硅胶做为一种异物长期存在体内引起非特异性免疫活动增强，但这方面尚需做进一步的临床与实验研究证实。

ugmentation mammoplasty with silicone breast implants,one of the most commonesthetic operations in china,is now in the ascendant here,at the same time, different complications ofthe surgery occur.Surgeons must understand the cause and means for prevention and treatment of thecomplications.In past ten years, one hundred and fifteen cases of the operation were performed in ourunit with both silicone gel and saline impants,nine of them experienced different complications includebleeding(2),hydrops(1),rupturef3) and asymmetry(3).The clinical manifestations,diagnosis and treat-ment were discussed in detail in this paper.In addition,the immune fonction of fifteen silicone-gel re-cipients was checked up voluntarily,Antinuclear antibody(ANA) and rheumatoid factor(RF) were neg-ative in all ofthem,levele of IgG and IgM were elevated in 20% of the patients, and complement C_3 wasincreased in 13.3% of the patients. They suggest that silicone breast implants may cause a nonspecificimmune reaction but further study in the field is necessary both in clinic and in laboratary.