曲安奈德联合维生素E预防硅凝胶假体植入后纤维包膜再挛缩

Prevention of fibrous capsule contracture using triamcinolone combined with vitamin E following silica gel prosthesis implantation

目的:观察曲安奈德与维生素E联合应用对预防二次隆乳后纤维包膜再挛缩的效果。方法:选择2002-08/2008-02南宁市第一人民医院整形美容外科收治的二次隆乳患者65例(130个乳房)作为治疗组,其中隆乳后纤维包膜挛缩(BarkⅢ级以上)松解假体再植入47例,注射隆乳术后凝胶取出后假体植入18例。治疗组患者二次隆乳后于假体植入腔穴内灌注曲安奈德混悬液,并服用维生素E胶丸3个月;另随机选择隆乳患者65例(130个乳房)为对照组。假体植入后半个月起随访,植入后1年评价疗效。以Baker纤维囊分级法作为评价标准。结果:治疗组及对照组130例患者均获得随访,随访时间6～24个月。治疗组65例患者(130个乳房)仅有3例(5个乳房)发生挛缩(BakerⅡ～Ⅲ级),挛缩率4%;明显低于对照组的13例(23个乳房),挛缩率18%(P<0.01)。在治疗组的全部病例中,无药物不良反应。结论:曲安奈德与维生素E联合应用可明显降低二次隆乳后乳房纤维包膜挛缩发生率。

OBJECTIVE： To observe the effect of triamcinolone combined with vitamin E on preventing fibrous capsule contracture following the second breast augmentation. METHODS： Totally 65 patients who had 130 breasts receiving the second breast augmentation at the Department of Plastic and Aesthetic Surgery, No. 1 People＇s Hospital of Nanning were collected and served as the treatment group, including 47 cases with capsules contracture and 18 cases with hydrogel clearing. Tri-Kort was injected after the second breasts augmentation, and vitamin E was taken orally for 3 months. Additional 65 cases with 130 breasts received the second breast augmentation were served as control group. The follow-up was performed after half month, and the curative effect was evaluated by Baker grading at 1 year after operation. RESULTS： All cases in the two groups were received 6 24 months follow-up. Only 3 cases （5 breasts） in 65 patients （130 breasts） in the treatment group had capsule contracture （Baker Ⅱ-Ⅲ）, with 3.8% of capsule contracture, which was obviously less than 18% of capsule contracture in the control group （P 〈 0.01, 13 cases with 23 breasts in the control group）. Simultaneously, no drug adverse reaction occurred in the treatment group. CONCLUSION： Triamcinolone combined with vitamin E can obviously depress the rate of capsule contracture after the second breast implantation.