A型肉毒毒素胸大肌注射对缓解假体隆乳术后疼痛的疗效观察(1)
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[摘要]目的：观察胸大肌注射A型肉毒毒素(BTXA)对于缓解胸大肌下假体隆乳术后疼痛的疗效。方法：对于2010年12月至2011年4月83例病例进行随机分成两组，注射组43例，在隆乳术中行双侧胸大肌下半部分多点注射A型肉毒毒素，总计100U；对照组40例，术中注射等量生理盐水，后完成手术。应用数字评分法(NRS)对两组术后疼痛情况进行评分统计例数，进行统计学分析。结果：注射组较对照组疼痛发生率，疼痛程度及疼痛时间均有明显下降，P<0.05,具有统计学意义。结论：术中应用A型肉毒毒素注射胸大肌，对于隆乳术后疼痛缓解，安全、有效。
[关键词]肉毒毒素；胸大肌；隆乳术；疼痛
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)01-0007-03
Effect about reducing pain after subpectoral breast aufmentation by injecting Botulinum toxim type A into pectoralis major muscle
WANG Yue-xing1,LIU Qing-yang2,WANG Rong2,PAN Shu-ya2,YANG Hong-bo2,YE Li-ping2,PENG Cai-xue2
(1.Luoyang Huamei Aesthetic and Plastic Hospital,Luoyang 471000,Henan,China;2.Shanghai Renai Hospital,Shanghai,200235,China)
Abstract: Objective To investigate the clinical effect of pain of patients after breast augmentation by injecting Botulinum toxin type A. Methods The 83 cases in our department from December 2010 to April 2011 were studied. Two groups were randomly divided: therapy group (43 cases) and control group(40 cases). The patients in therapy group were given intramuscular injection of BTXA into pectoralis major muscle in the operation,the dose is 100U,and those in control group were only given the same dose of 0.9% sodium chloride solution,Every patient pain after operation was evaluated by using Numerical Rating Scales (NRS) and the scores of every grate patient were recorded. Results The number of the pain patients and the pain level in control group were obviously higher than them in therapy group (P<0.05). Conclusion The injection of BTXA into pectoralis major muscle can relieve the pain after breast augmentation, it's a safe and effective method.
Key words:botulinum toxin type A; pectoralis major muscle; breast augmentation;pain
随着生活水平的提高，女性对于美容方面的关注，近些年来，美容手术量与日俱增，而假体隆乳术以安全，有效，自然的特点以为广泛接受，成为当下最流行的美容手术之一，而假体隆乳术后普遍存在早期的术后疼痛的并发症，一定程度上影响患者的就诊率和术后的满意率。而患者术后术区疼痛与假体压迫和胸大肌的收缩活动有明显的相关性，其也是术后疼痛的主要原因，笔者根据应用A型肉毒毒素肌肉注射可以阻断神经末梢和肌肉接头的受体联系，从而减少局部胸大肌活动，并且减小胸大肌表面张力，从而减小假体压迫，最终降低假体隆乳术后疼痛。通过临床应用，发现隆乳术中同时注射A型肉毒毒素可以有效缓解硅凝胶假体隆乳术后疼痛，效果满意。
1 临床资料
对于2010年12月～2011年4月的83例病例进行研究，年龄20～37岁，平均25岁，小乳症71例，产后乳房萎缩伴轻微下垂的12例，均为双侧，采用胸大肌下假体隆乳术，植入假体均为毛面硅凝胶假体，容量200～320ml，圆形65对，水滴形18对。83例研究对象随机分为两组 ......
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