聚左旋乳酸组织填充前回抽-提升注射安全性

Aspiration before poly-l-lactic acid tissue filling-Safety enhancement

目的临床上注射组织填充剂时,即使回抽误注入血管中的针剂,仍然有可能发生「扎入血管后回抽却没发生血液回流」的现象称之为回抽的伪阴性。本论著将透过回抽聚左旋乳酸针剂证实回抽伪阴性的存在,并提供简单有效的方法从而避免其发生以增加临床的注射安全性。方法回抽伪阴性发生的关键在于回抽的时间,因此设计将一个3ml的针筒装满人类新鲜血液以模拟体内血管情形,再将聚左旋乳酸针剂插入3ml的模拟血管中回抽,纪录是否立即性发生血液回流,并且以不同的聚左旋乳酸注射针头的尺寸、不同的剩余剂量及不同的泡制时间等差异做为操纵变因观察其栓塞情形。结果将聚左旋乳酸针剂插入模拟血管后回抽,在不同尺寸的针头;不同剩余剂量以及不同的泡制时间下,血液回流的速度相当快,几乎立即性发生回血,用肉眼辨识几乎无法测量等待时间,420次实验当中仅有5次没有立即性回血,发生率约1.2%。结论根据实验结果,透过SPSS检验证实使用聚左旋乳酸注射制剂填充时,将不受到其泡制时间长短、针头大小、残余剂量的影响,若能在注射前习惯性回抽,于刺入血管的前提下将可以立即辨识回血发生推估可能误将针头扎入血管,从而停止操作将可以增加注射过程的安全性。

Objectivs The blood might not return while pulling back the syringe from its needle do be mis-inserted into vessel.It is defined as false negative of the sign of aspiration.Aim to enhance the safety while injecting with PLLA filler,this essay proves the false negative of aspiration do exist and provide an effective way to avoid it.Methods The key point of the false sign occur is timing.Hence,we take a 3ml syringe with fully fresh blood to simulate vessel in vitro.After that we have another PLLA syringe inserted into the 3ml-syringe vessel simulator.Furthermore,the operating factors would be set by the size of needles,residual dosage,and the preparing time of PLLA.Results In our experiment,we use the different sizes of needles,different residual dosages or different preparing time of PLLA anyhow,almost all of them occurred the blood return immediately which was too fast to calculate the timing.Among 420 times of the experiment,the false negative had occurred only for 5 times.The rate of it is only 1.2%.Conclusions It has been proven by SPSS that the aspiration wouldn’t be influenced by the operating factors mentioned above.Those factors are set by common-seen clinical situations.If doctors regularly do aspirate before giving injection,blood return would be recognized easily no meter which equipment was chosen to use.This way may do a favor to enhance the safety of PLLA injections.