透明质酸面部注射填充术后血管并发症的治疗体会及分析

Experience and analysis of 20 cases of vascular complications after facial filling with hyaluronic acid

目的探讨透明质酸面部注射填充术后血管并发症治疗的临床疗效。方法自2014年12月至2016年11月,收治了20例透明质酸注射后发生血管并发症的患者,就诊时间均在注射4 h以上。早期由于经验不足,对6例患者采取单纯透明质酸酶局部注射溶解治疗(单一治疗组),后期对14例患者采取透明质酸酶溶解+血管活性药物+高压氧治疗的综合治疗(综合治疗组),分别对两种治疗方法的创面愈合时间及瘢痕形成率进行统计学分析。结果单一治疗组创面愈合时间为(10.0±2.2)d,综合治疗组创面愈合时间为(7.5±1.8)d,两组比较差异有统计学意义(P<0.05)。单一治疗组瘢痕形成率为(27.0±3.6)%,综合治疗组瘢痕形成率为(16.0±2.8)%,两者比较差异有统计学意义(P<0.05)。结论透明质酸酶联合血管活性药物及高压氧治疗对透明质酸面部注射术后血管并发症的治疗具有重要意义。

Objective To explore an ideal solution for early blood supply disorder treatment after facial filling with hyaluronic acid.Methods From December 2014 to November 2016,20 patients with early vascular complilcations were involved in the study.Time of treatment all exceeded 4 hours after injection.Patients were divided into 2 groups according to different treatment strategies,with 6 cases in the single treatment group （hyaluronidase） and 14 cases in the comprehensive treatment group （hyaluronidase ＋ vasoactive agent ＋ hyperbaric oxygen）.The wound healing time and scar incidence rate of both groups were analyzed statistically.Result The wound healing time in the single treatment group was （10.0 ± 2.2） days and （7.5 ± 1.8） days in the comprehensive treatment group.There was statistical difference between the two groups.The scar incidence rate in the single treatment group was （27.0 ± 3.6）% and （16.0 ± 2.8）% in the comprehensive treatment group.There was statistical difference between the two groups.Conclusion The combination of hyaluronidase,vasoactive and hyperbaric oxygen plays an important role in the treatment of vascular complications.The effect was better than hyaluronidase treatment alone.