聚丙烯酰胺水凝胶注射隆乳后的并发症及治疗

目的探讨聚丙烯酰胺水凝胶（polyacrylamide hydrogel，PAHG）注射隆乳后的并发症及治疗方法。方法对l74例术前行乳房超声或磁共振成像（MRI）检查以确定PAHG分布范围。采用乳晕切口行组织分离，生理盐水灌洗，清除PAHG，切除异常组织；其中对继发乳房畸形者选择性地以胸大肌后间隙假体置人进行修复87例（50％，48例I期，39例Ⅱ期）。结果术后随访3～6个月，绝大部分症状得到缓解。77例（44．3％）对乳房外形、手感满意；10例（5．7％）对手感不太满意；79例（45．4％）出现乳房下垂或扁平胸；8例（4．6oA）出现较重的乳房畸形。结论PAHG注射隆乳术后出现并发症者，应尽早清除，治疗方法得当可取得较好疗效，但完全满意者较少。穿刺盲视抽吸的方法不可取，以开放式手术为佳，有强烈要求及条件允许者可行乳房假体置人重建术。

Treatment of postoperative complications after augmentation mammoplasty by polyacrylamide hydrogelinjection

Objective To explore the complications of augmentation mammoplasty by polyacryl- amide hydrogel （PAHG） injection and their management. Methods Preoperatively, 174 patients un derwent breast ultrasound image, and some patients received magnetic resonance imaging （MRI） to ascertain the distribution of injected PAHG. We used the periareolar incision and dissection extended to the subcutaneous tissue, mammary gland, and subgland space. We were able to suck most of the gel by the negative pressure machine and remove the abnormal breast tissue. The secondary breast de formity was repaired with subpectoral placement of silicone mammary implants （48 cases immediately, 39 cases secondarily after 3 6 months） according to the individual situation. Results Following-up for 3 to 6 months, most of their symptoms were relieved after removal of the polyaerylamide hydrogel. In the patients who were performed with the implants augmentation mammoplasty, 77 cases gained saris factory results on the shape and texture of the breast （44. 3%）, and 10 cases were not satisfied with texture of the breast （,5.7%）. 79 cases appeared breast atrophy or flat chest （45.4%）. The severe breast deformities occurred in 8 cases （4.6%）. Conclusions PAHG should be removed with surgical operation as soon as possible. The open operative technique via periareolar incisions may be a better method for the patients. The breast reconstruction is performed with implants prosthesis for those who are suitable and willing after removal of PAHG.