1%聚桂醇注射液治疗吸脂术后血清肿的效果观察(1)
[摘要]目的：探讨1%聚桂醇注射液硬化治疗吸脂术后血清肿的临床疗效。方法：28例吸脂术后血清肿患者，在抽尽囊腔积液后注入1%聚桂醇注射液后加压包扎。术后1周来院评估疗效，如血清肿未见明显缩小，则重复硬化治疗1次。经2次硬化治疗后血清肿仍未见明显缩小者，改行囊腔搔刮联合负压引流治疗。结果：28例患者中，23例经1次硬化治疗治愈；3例经第2次硬化治疗后治愈；另有2例经2次硬化治疗后未见明显改善，行小切口囊腔内搔刮联合负压引流后治愈。结论：应用1%聚桂醇注射液硬化治疗吸脂术后血清肿简易安全且疗效好，值得临床推广。
[关键词]聚桂醇；硬化治疗；吸脂术；超声；血清肿
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)05-0046-03
The Effect Observation of 1% Lauromacrogol Injection in the Sclerotherapy of Post-liposuction Seroma
, 百拇医药
JIANG Zhao-long，SHI Gao-feng，LI Hu，GAO Feng-shan
(Department of Plastic Surgery，Affiliated Hoapital，Jiangnan University，Wuxi 214062，Jiangsu，China)
Abstract： Objective To investigate the clinical efficacy of 1% lauromacrogol injection in the sclerotherapy of post-liposuction seroma. Methods Twenty-eight patients with post-liposuction seroma were treated in our department. After the fluid in the cavity of seroma was drained thoroughly， 1% lauromacrogol was injected into the cavity. Then compression bandaging was applied locally. The efficacy was assessed one week after the procedure. If no significant reduction of seroma was found， sclerotherapy would be repeated. When seroma was not reduced significantly after twice sclerotherapies， curettaging the cystic walls combined with placing vacuum sealing drainage was performed. Results Among all the patients， twenty-three of them were cured after one-time sclerotherapy， while three of them were cured after the second sclerotherapy. However，no obvious efficacy was discovered in two cases the second sclerotherapy. Then the remaining two patients were cured through curettaging the cystic walls combined with placing vacuum sealing drainage. Conclusion Sclerotherapy of post-liposuction seroma with 1% lauromacrogol injection was simple， safe and effective. It was worthy of clinical popularization.
, 百拇医药
Key words： lauromacrogol； sclerotherapy； liposuction； ultrasound； seroma
随着吸脂设备及技术的不断改进和完善，及对相关理论的深入研究，吸脂术已经成为一种安全、有效的美容手术[1]。然而吸脂术总会伴随着不同性质和不同程度的并发症[1]。血清肿为吸脂术后局部并发症的一种，发生率为2%～3%，临床常用处理方法包括反复穿刺抽液、加压包扎、囊壁搔刮、放置负压管引流及手术切除包囊囊壁等[1-3]。硬化治疗作为血清肿的一种新治疗方式，具有疗效确切、操作简易、创伤小、痛苦小及患者接受度高等优点[4]。笔者科室于2012年8月-2017年12月应用1%聚桂醇注射液硬化治疗吸脂术后血清肿患者28例， 取得了满意疗效， 现报道如下。
1 资料和方法
1.1 临床资料：本组共28例患者，均为女性，年龄21～55岁。曾在笔者科室接受过吸脂术，术后门诊随访发现血清肿，确诊后立即按传统方法予以穿刺抽吸及局部加压包扎，首次治疗后2周内嘱患者每隔2～3d来院复诊，如复诊发现血清肿无明显缩小则重复治疗1次。如随访2周后仍未见明显缩小，与患者沟通并经其同意后，使用1%聚桂醇注射液对血清肿进行硬化治疗。本组患者中腹部吸脂术后血清肿14例，大腿吸脂术后血清肿10例，肩背部脂肪瘤吸脂术后血清肿3例，颈项部脂肪垫吸脂术后血清肿1例。全部病例凝血项目及肝肾功能正常，无重要脏器器质性疾病。
1.2 治疗方法：在病房换药室或门诊手术室进行，对血清肿部位常规消毒、铺无菌巾，血清肿低位处，根據血清肿大小选择50ml或20ml注射器，穿刺后反复抽吸，同时向穿刺点推按肿胀区，尽量抽尽囊腔内积液；然后注入1%聚桂醇注射液(陕西天宇制药有限公司，国药准字：H20080445)，并根据血清肿的范围，决定其剂量，一般为5～10ml；操作完毕后按压穿刺点3～5min，同时适当按摩血清肿部位，使药液在囊腔内充分弥散，局部垫无菌敷料后，根据不同部位选择弹力绷带、腹带或塑形衣加压包扎。, http://www.100md.com(蒋朝龙 史高峰 李虎 高凤山)
[关键词]聚桂醇；硬化治疗；吸脂术；超声；血清肿
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)05-0046-03
The Effect Observation of 1% Lauromacrogol Injection in the Sclerotherapy of Post-liposuction Seroma
, 百拇医药
JIANG Zhao-long，SHI Gao-feng，LI Hu，GAO Feng-shan
(Department of Plastic Surgery，Affiliated Hoapital，Jiangnan University，Wuxi 214062，Jiangsu，China)
Abstract： Objective To investigate the clinical efficacy of 1% lauromacrogol injection in the sclerotherapy of post-liposuction seroma. Methods Twenty-eight patients with post-liposuction seroma were treated in our department. After the fluid in the cavity of seroma was drained thoroughly， 1% lauromacrogol was injected into the cavity. Then compression bandaging was applied locally. The efficacy was assessed one week after the procedure. If no significant reduction of seroma was found， sclerotherapy would be repeated. When seroma was not reduced significantly after twice sclerotherapies， curettaging the cystic walls combined with placing vacuum sealing drainage was performed. Results Among all the patients， twenty-three of them were cured after one-time sclerotherapy， while three of them were cured after the second sclerotherapy. However，no obvious efficacy was discovered in two cases the second sclerotherapy. Then the remaining two patients were cured through curettaging the cystic walls combined with placing vacuum sealing drainage. Conclusion Sclerotherapy of post-liposuction seroma with 1% lauromacrogol injection was simple， safe and effective. It was worthy of clinical popularization.
, 百拇医药
Key words： lauromacrogol； sclerotherapy； liposuction； ultrasound； seroma
随着吸脂设备及技术的不断改进和完善，及对相关理论的深入研究，吸脂术已经成为一种安全、有效的美容手术[1]。然而吸脂术总会伴随着不同性质和不同程度的并发症[1]。血清肿为吸脂术后局部并发症的一种，发生率为2%～3%，临床常用处理方法包括反复穿刺抽液、加压包扎、囊壁搔刮、放置负压管引流及手术切除包囊囊壁等[1-3]。硬化治疗作为血清肿的一种新治疗方式，具有疗效确切、操作简易、创伤小、痛苦小及患者接受度高等优点[4]。笔者科室于2012年8月-2017年12月应用1%聚桂醇注射液硬化治疗吸脂术后血清肿患者28例， 取得了满意疗效， 现报道如下。
1 资料和方法
1.1 临床资料：本组共28例患者，均为女性，年龄21～55岁。曾在笔者科室接受过吸脂术，术后门诊随访发现血清肿，确诊后立即按传统方法予以穿刺抽吸及局部加压包扎，首次治疗后2周内嘱患者每隔2～3d来院复诊，如复诊发现血清肿无明显缩小则重复治疗1次。如随访2周后仍未见明显缩小，与患者沟通并经其同意后，使用1%聚桂醇注射液对血清肿进行硬化治疗。本组患者中腹部吸脂术后血清肿14例，大腿吸脂术后血清肿10例，肩背部脂肪瘤吸脂术后血清肿3例，颈项部脂肪垫吸脂术后血清肿1例。全部病例凝血项目及肝肾功能正常，无重要脏器器质性疾病。
1.2 治疗方法：在病房换药室或门诊手术室进行，对血清肿部位常规消毒、铺无菌巾，血清肿低位处，根據血清肿大小选择50ml或20ml注射器，穿刺后反复抽吸，同时向穿刺点推按肿胀区，尽量抽尽囊腔内积液；然后注入1%聚桂醇注射液(陕西天宇制药有限公司，国药准字：H20080445)，并根据血清肿的范围，决定其剂量，一般为5～10ml；操作完毕后按压穿刺点3～5min，同时适当按摩血清肿部位，使药液在囊腔内充分弥散，局部垫无菌敷料后，根据不同部位选择弹力绷带、腹带或塑形衣加压包扎。, http://www.100md.com(蒋朝龙 史高峰 李虎 高凤山)
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