注射隆鼻术中引发血管栓塞和动眼神经损伤的临床治疗

Clinical Treatment of Vascular Embolism and Oculomotor Nerve Injury During Rhinoplasty by Injection

目的:探讨注射隆鼻术中引发的血管栓塞和动眼神经损伤的对症紧急处置及后续治疗。方法:对2例注射隆鼻术中出现血管栓塞且其中1例合并有动眼神经受损的患者紧急进行玻璃酸酶注射、抗感染、扩血管、营养神经、改善局部组织微循环和高压氧舱等多种促进局部皮肤血运、减压和营养神经等对症治疗及护理。结果:患者因血管栓塞引发的血运障碍恢复正常,无明显瘢痕残留;其中1例合并有动眼神经受损患者已康复,处理后90d随诊,局部皮肤未见异常,眼科检查未见明显异常。结论:注射隆鼻术中小血管栓塞引发的皮肤血运障碍和眼部视力感觉异常,采取积极对症紧急处置和后续眼科专项特殊对症救治,可有效避免并发症的产生,获得良好愈后。

Objective To discuss the emergency treatment and follow-up treatment of vascular embolism and oculomotor nerve injury caused by injection for rhinoplasty.Methods There were multiple therapeutic methods to promote skin circulation,reduce pressure of affected area and give nutrition to patients with embolism.The methods included injecting hyaluronidase using anti-infection,dilating blood vessels,nourishing nerve system,accelerating circulation system,and hyperbaric oxygen therapy.Results Patients with vascular impairment caused by vascular embolization returned to normal and no residual scar remained.One cases of patients with oculomotor nerve injury were recovered after 3 months,and there was no abnormal skin in the local skin and no obvious abnormalities in the ophthalmology examination.Conclusion It is effective to take therapeutic procedures to help patients with embolism as well as oculomotor nerve damage causing by injection for rhinoplasty.