透明质酸填充剂并发症的认知与防治：文献回顾与临床经验总结

Recognition of complications from hyaluronic acid filler and its prevention and treatment： a review of literatures and summary of clinical practice

目的总结及探讨透明质酸填充剂引发并发症的病因及防治措施。方法自2011年11月至2013年8月，处理透明质酸注射后血管阻塞2例，局部感染1例，局部过敏9例，填充剂移位3例，结节7例，毛细血管扩张2例，色素沉着4例。结合国内外文献对相关病例进行分析总结。结果2例血管阻塞患者经及时处理后，均未发生皮肤坏死等不良结果。1例感染患者局部病灶得到控制，预后良好。9例过敏患者，其中6例反复发作，应用透明质酸酶溶解后，症状消失，3例偶发患者口服药物后症状有所缓解。3例移位者矫治满意。7例结节患者经按摩或透明质酸酶溶解后，全部消失。2例毛细血管扩张及4例局部色素沉着患者经激光治疗后，得到明显改善，效果满意。结论透明质酸注射后发生的各种并发症在及时正确的认识并进行积极妥当的处理后，可以得到较满意的矫治效果，以最大程度的降低了不良后果。

Objective To summarize and analyze the etiology of complications from hyaluronic acid （HA） filler, exploring its prevention and treatment. Methods From November 2011 to August 2013, the complications of HA filler including embolism （2 cases）, regional infection （ 1 case）, regional allergic reactions （9 cases）, filler migrations （3 cases）, nodules （7 cases）, telangiectasia （2 cases） and four cases of pigmentations （4 cases） have been treated. Combining with the relative literatures, analysis and summary of these correlated cases were performed. Results After prompt treatment, two patients with embolism were had no serious sequelae such as cutaneous necrosis; local lesion infection on one patient was well controlled with a good prognosis. In nine pa- tients with allergic reaction, six who repeatedly recurred were cured after the administration of hyaluronidase, the other three relieved by taking medicine orally, three patients with filler migration were satisfied with corrected resuits, the nodules on seven patients disappeared completely by administering hyaluronidase or massage, laser therapy offered an efficacious treatment for two patients with telangiectasia and four patients with pigmentation. Conclusion Prompt recognition and proper treatment of complications from HA filler can moderate and even prevent serious sequelae.