聚丙烯酰胺水凝胶隆乳术后并发症分布的Meta分析

Meta-analysis of Postoperative Complications of Polyacrylamide Hydrogel Injection for Augmentation Mammoplasty

目的:了解聚丙烯酰胺水凝胶注射隆乳术后各类并发症的分布率。方法:检索中英文数据库,如PubMed、Embase、万方、中国知网等,搜索关于聚丙烯酰胺水凝胶注射隆乳术后并发症的所有类型的相关研究,检索时限为从建库至2020年3月1日。筛选后用R 3.5.1软件对并发症分布率进行Meta分析。结果:最终共纳入10篇文献,包括565例患者。数据分析显示,硬结与包块是聚丙烯酰胺水凝胶注射隆胸术后最主要的并发症(66.0%),其次是疼痛(56.8%),注射物游走、乳房变形、双乳不对称分别占16.5%、18.2%和21.1%,感染和血肿分别占8.1%和10.9%,皮肤破溃、窦道7.4%,上肢外展受限4.4%,材料渗漏4.7%。Meta分析显示并发症中硬结与包块的分布率为57.2%(95%CI:44.6%~69.4%),疼痛46.1%(95%CI:29.9%~62.6%),双侧乳房不对称19.7%(95%CI:15.0%~24.8%),乳房变形18.3%(95%CI:12.4%~25.1%),注射物游走15.9%(95%CI:12.9%~19.2%),感染9.3%(95%CI:6.6%~12.4%)。结论:聚丙烯酰胺水凝胶注射隆乳术后并发症主要以硬结与包块、术后疼痛最常见,其次有双乳不对称、乳房变形、注射物游走和感染等主要并发症,为注射隆乳术后并发症患者的个性化治疗提供了可靠的流行病学依据。

Objective To investigate the distribution rates of various complications after polyacrylamide hydrogel injection for augmentation mammoplasty.Methods English and Chinese databases,such as PubMed,Cochrane Library,Embase,Web of Science,Wanfang Data,CNKI,VIP and CBM were used to search all types of related studies on complications of polyacrylamide hydrogel injection for augmentation mammaplasty.The retrieval time was from the establishment of the databases to March 1,2020.Meta-analysis was using to calculate the distribution rates of various complications by R 3.5.1.Results A total of 10 studies met the inclusion criteria,and a total of 565 women were involved.It was demonstrated that indurations and lumps were the most common complications(66.0%),and the other main complications included pain(56.8%),displacement(16.5%),breast deformity(18.2%),asymmetry(21.1%),infection(8.1%),hematoma(10.9%),skin ulceration(7.4%),limitation of arm movement(4.4%)and materials leakage(4.7%).Outcomes in Meta-analysis demonstrated that in total the prevalence rate of indurations and lumps was 57.2%(95%CI:44.6%-69.4%),and 46.1%(95%CI:29.9%-62.6%)for pain,19.7%(95%CI:15.0%-24.8%)for asymmetry,18.3%(95%CI:12.4%-25.1%)for breast deformity,15.9%(95%CI:12.9%-19.2%)for displacement,and 9.3%(95%CI:6.6%-12.4%)for infection.Conclusion There are many complications after augmentation mammaplasty with polyacrylamide hydrogel,and the most common complications are indurations,lumps and pain.Additionally,the main complications also include asymmetry,breast deformity,displacement and infection.It provides a reliable epidemiological evidence for personalized treatment of patients that underwent augmentation mammaplasty with polyacrylamide hydrogel.