注射溶脂瘦脸术后并发面部非结核分支杆菌感染应对策略

Strategies for coping with non-tuberculous mycobacterial infection after lipolysis injection

目的总结注射溶脂瘦脸术后并发面部非结核分支杆菌感染患者应对干预策略,旨在为临床提供借鉴。方法对2015年1月至2018年6月河南省某三甲医院收治的注射溶脂瘦脸术后并发面部非结核分支杆菌感染的5例患者实施切开清创引流,给予抗感染、抗结核、保肝等药物综合治疗,重视患者心理支持、创面引流及间断冲洗、创面换药及理疗,出院后继续坚持抗结核治疗6~12个月,随访2年。结果经23~90d院内清创、抗结核、保肝及针对性干预支持,5例患者感染病灶均得到有效控制,平均治疗时间(56.2±9.5)d;出院后复发1例,继续住院系统治疗至痊愈。其中4例患者面部感染病灶愈合良好,疤痕不明显,1例患者存在瘢痕增生伴色素沉着,接受系统激光祛斑治疗后效果良好,所有患者对面部容貌保持效果表示满意。结论临床实施面部注射溶脂瘦脸术应充分做好患者准备,一旦出现非结核分支杆菌感染应尽早给予抗感染、抗结核和保肝治疗,同时注意患者心理干预及病灶清创后创面管理,尽可能减少对面部容貌的损害。

Objective Summarize the intervention strategies for patients with facial nontuberculous mycobacterial infection after lipolysis and face-lifting,aiming to provide clinical reference.Methods From January 2015 to June 2018,5 patients with facial non-tuberculous mycobacterial infection after lipolysis and face-lifting who were admitted to a third-class hospital in Henan Province were treated with incision debridement,anti-infection,anti-tuberculosis,and liver protection.Comprehensive treatment with other drugs,pay attention to patients'psychological support,wound drainage and intermittent washing,wound dressing and physical therapy,and continue to adhere to anti-tuberculosis treatment for 6-12 months after discharge,and followup for 2 years.Results After 23-90 days in-hospital debridement,anti-tuberculosis,liver protection,and targeted intervention support,the infected lesions of the 5 patients were effectively controlled,and the average treatment time was(56.2±9.5)days;1 case relapsed after discharge,and continued hospitalization until get well.Among them,4 patients with facial infection lesions healed well,but scars were not obvious.1 patient had scar hyperplasia with hyperpigmentation.After receiving systematic laser freckle treatment,the effect was good.All patients were satisfied with the facial appearance maintenance effect.Conclusion In clinical implementation of facial lipolysis and face-lifting,p atients should be fully prepared.Once non-tuberculous mycobact erial infection occurs,anti-infection,anti-tuberculosis and liver protection treatments should be given as soon as possible.At the same time,attention should be paid to patient psychological intervention and wound management after lesion debridement.Reduce damage to facial appearance.