聚丙烯酰胺水凝胶注射隆乳术后局部和全身症状研究

The Local and General Symptoms after Breast Augmentation by Polyacrylamide Hydrogel

目的了解女性注射聚丙烯酰胺水凝胶隆乳术后局部和全身症状的发生情况及病理表现,试探讨症状发生原因。方法回顾性选择2003年4月—2008年12月在协和医院整形外科住院的聚丙烯酰胺水凝胶注射隆乳术后行取出术患者100例作为注射组,选择同期行假体植入隆乳术患者100例作为假体植入组。按照入选条件筛查,采用自行设计的调查表记录研究内容(一般资料、临床资料、术前体温最高值)。结果两组患者年龄、体质量比较差异无统计学意义(P>0.05)。注射组局部症状以硬结和疼痛最常见,发生率分别为74%和58%;全身症状为注射组体温较假体植入组高(t=8.528,P<0.01),升高幅度虽然不大,但差异有统计学意义,且注射组体温升高与注射量呈正相关(P<0.05),与注射年限无相关性(P>0.05)。病理结果提示:出现慢性炎性反应、巨细胞反应和肉芽肿形成的总发生率为78%。结论聚丙烯酰胺水凝胶注入人体后,易引发异物反应,慢性炎症会导致全身性症状,即体温与健康女性相比有升高,且注射量越多,机体针对异物的免疫反应越强烈。建议注射聚丙烯酰胺水凝胶隆乳女性,应尽早取出异物。

Objective To understand the local and general symptoms after breast augmentation by polyacrylamide hydrogel as well as the pathological manifestation so as to study the etiological factors of the symptoms. Methods Retrospectively, 100 clients undergoing dislodgment after breast augmentation by polyacrylamide hydrogel hospitalized in the department of plastic surgery during April 2003 to December 2008 were assigned into injection group and another 100 clients undergoing breast augmentation by implanting prothesis in the department at the same period into prothesis group. A self-designed questionnaire was used to survey the general data, clinical data and maximum of preoperative body temperature. Results There were no differences in age and body mass between the two groups （/）〉0.05）. In the injection group, the local symptoms were mainly induration and pains, with respective incurrences of 74% and 58%. The body temperature in the injection group was higher than that of prothesis group （t=8.528, P〈0.01）. The increased temperature was positively related to injection volume （P〈0.05） but not related to injection time （P〉0.05）. Pathologically, the general incidence of chronic inflammatory, response, giant cell reaction and granuloma was 78%. Conclusion The breast augmentation by polyacrylamide hydroogel is liable to foreign body reaction. The chronic inflammatory response can cause general symptoms like increase of body temperature. The large the volume in injection, the powerful the immune reactions to foreign bodies. It is suggested to dislodge the foreign bodies for those ladies having undergone breast augmentation by polyacrylamide hydrogel.