六种隆乳材料生物相容性和安全性的比较

Experimental studies on the biocompatibility and safety of six implantation prosthesis

目的 比较 6种隆乳材料生物相容性和安全性。方法 以 12只Beagle犬为研究对象 ,通过HE染色、Van Gieson染色 ,比较交联透明质酸钠假体 (CSHP)、非交联透明质酸钠假体 (NCSHP)、甲基纤维素假体 (CMCP)、硅凝胶假体 (SGP)、亲水性聚丙烯酰胺凝胶假体 (HPAGP )、注射用聚丙烯酰胺凝胶 (IHPAG)所致机体局部组织反应的强弱程度。结果 6种材料引起的早期 (术后 14、30d)组织反应表现为 :NCSHP、CMCP、HPAGP周围炎症反应最重 ;CSHP、SGP次之 ,IHPAG最轻微。 30d后 ,6种材料周围均形成纤维包膜囊 ,但构成纤维膜的成分及其排列随材料不同而异 ,且随时间推移 ,各材料周围纤维包膜囊的结构及排列均发生不同程度的变化。NCSHP、CMCP、HPAGP的包膜有明显收缩倾向 ,并在2年后均发生不同程度挛缩。CSHP、SGP未见明显挛缩倾向 ,2年后 ,纤维包膜仍较薄并有弹性。IH PAG的包膜 2年后仍松软而有弹性。结论 SGP作为一种较为成熟的隆乳材料 ,生物相容性及美容效果均是目前较为理想的材料 ;CSHP的生物相容性虽较好 ,但美容效果相对较差 ,且存在渗漏问题 ,需对材料进一步改进 ;IHPAG引起的炎症反应轻微 ,生物相容性好 ,具有应用前景 ,但若注射层次掌握不好 ,材料易被纤维组织分割 ,影响美容效果 ,因此在临床应用中 。

Objective To compare biocompatibility and safety of six implantation prosthesis. Methods Subcutaneous implantation of crosslinked sodium hyaluronate prosthesis (CSHP), silica gel prosthesis(SGP), non crosslinked sodium hyalurorate prosthesis (NCSHP), carboxy methycel prosthesis (CMCP), hydrophilic polyacrylamide gel prosthesis (HPAGP), injectable hydrophilic polyacrylamide gel (IHPAG) was performed in 12 beagle dogs.Local reaction of surrounding tissues of the transplants were observed with HE and Van Gieson stains after the transplantation at 14, 30 and 90 days, 6 months, and 1 and 2 years. Results The most serious reaction was observed in NCSHP, CMCP and HPAGP, moderate reaction in CSHP and SGP and mild reaction in IHPAG. Van Gieson staining showed that collagenous fibrous capsule around implanted prosthesis was formed from 30 days to 2 years .The component and arrangment of the capsule were different among the defferent prosthesis, but changed with time. Shrinkage of the capsules was found in NCSHP, CMCP and HPAGP, and contraction occurred two years later. The capsules formed by CSHP and SGP had no contraction after two year implantation. IHPAG capsule was still soft and elastic after 2 years. Conclusions SGP is one of the best material for breast enlargement with a good biocompatobility and soft capsule. IHPAG is a new filling material with mild inflammatory reaction and thinner and softer capsule. CSHP should be improved further because its molding effect is not gratified. Both the biocompatibility and molding effect of NCSHP, CMCP and HPAGP are not gratified and further modification is needed.