透明质酸或自体脂肪面部注射并发眼动脉及脑动脉阻塞临床研究

目的 观察透明质酸或自体脂肪面部注射并发眼动脉及脑动脉阻塞的临床特征,分析其发病机制,探讨治疗效果及预后.方法 采用回顾性病例分析研究法,纳入2015年1月～2020年9月南阳市某院收治的21例透明质酸或自体脂肪面部注射后发生眼动脉及脑动脉阻塞患者,对其注射部位、注射物质、阻塞部位、临床症状、影像检查等临床资料进行分析...

Clinical study of facial injection of hyaluronic acid or autologous fat with occlusion of ophthalmic artery and cerebral artery

Objective Observe the clinical characteristics of hyaluronic acid or autologous fat facial injection complicated by ophthalmic artery and cerebral artery occlusion.analyze its pathogenesis,and discuss the treatment effect and prognosis.Methods A retrospective case analysis method was used to enroll 21 patients with ophthalmic and cerebral artery obstruction after facial injection of hyaluronic acid or autologous fat who were admitted to a hospital in Nanyang from January 2015 to September 2020.Their injection site and injection Analyze clinical data such as substance,obstruction site,clinical symptoms,and imaging examination.All patients were treated with urokinase thrombolysis and vasoactive drugs.Patients with limb dysfunction were treated with hyperbaric oxygen therapy,and those with local injection edema and ulcers were treated with local hyaluronidase injection.Results Among 21 patients,16 cases were injected with hyaluronic acid(76.19%),5 cases were injected with autologous fat(23.81%);the injection site was in the nasolabial region in 6 cases(28.57%),the nose was in 5 cases(23.81%),and the temporal region 3 cases(14.29%),3 cases(14.29%)between the eyebrows,2 cases(9.52%)in the orbital area,2 cases(9.52%)in the forehead;7 cases(33.33%)in simple ophthalmic artery occlusion,and 5 cases in simple cerebral artery occlusion Of the 3 cases(23.81%),9 cases(42.86%)of ophthalmic artery complicated with cerebral artery obstruction;7 cases(33.33%)combined with injection site edema,ischemic ulceration and necrosis;MRI revealed 5 cases of new intracranial ischemic focus(23.81%).After medical treatment and neurological rehabilitation,3 months later,the eyesight of the patients with ophthalmic artery obstruction did not recover,the NIHSS score and limb function of cerebral artery obstruction patients were significantly improved,the local ulcers healed,and the scar score(4.16±0.85)points.Conclusion Ophthalmic artery and cerebral artery obstruction is one of the serious complications of facial injection.Neurological function and local vascular complications can be improved after corresponding treatment.However,blindness caused by ophthalmic artery obstruction is difficult to treat.Therefore,prevent it when injecting into the face.Measures are critical.