聚丙烯酰胺水凝胶隆乳后再次取出方法的探讨

摘要

目的 对聚丙烯酰胺水凝胶隆乳后的再取出方式进行探讨.方法 对在外院行乳房内聚丙烯酰胺水凝胶取出不完全者17例,采用乳晕下半弧形切口,切除包括聚丙烯酰胺水凝胶及部分肌肉和腺体在内的变性组织.结果 术前MRI及CT检查可见乳房内组织层次紊乱,手术后组织内仅可见少量水凝胶残留.切除组织病理结果显示:增生变性纤维结缔组织间可见散在异物,伴巨细胞反应及大量中性粒细胞、异物性肉芽肿.患者症状如乳房内肿块或硬结、胸背部疼痛、感染等术后基本消失.结论 采用直视下水凝胶清除及变性组织切除的方法,并结合影像学的检查依据,可以最大限度地取出聚丙烯酰胺水凝胶.%Objective To investigate the technique of repeated operation for removement of polyacrylamide hydrogel from breast.Methods 17 cases after uncomplete removement of PHG were reoperated through inferior periareolar incision.The PHG and affected denatured muscle and gland tissue were removed.Results Preoperative MRI or CT showed PHG distributed diffusely in muscle and gland.There was only minimal residual PHG after operation.Histological examination showed PHG distributed in the denatured and proliferative fibrous tissue,including giant cells,many neutrophilic cells inftltration,and foreign body grannuloma.The symptoms,such as intramammary pump or nodule,chest and back pain,infection,were relieved after operation.Conclusions Blinded suction technique can not remove PHG completely and can also result in malposition of PHG and make the tissue denaturation worse.We suggest open approach to remove the PHG and denatured tissue completely through periareolar incision.