基于病例报告、病例系列和临床经验的系统评价制定的透明质酸相关并发症治疗算法
Treatment Algorithm for Hyaluronic Acid-Related Complication Based on a Systematic Review of Case Reports, Case Series, and Clinical Experience.
作者信息
Aviv Uri, Haik Josef, Weiss Nathaniel, Berl Ariel, Ofir Hagit, Nardini Gil, Cleary Michelle, Kornhaber Rachel, Harats Moti
机构信息
Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Craniomaxillofac Trauma Reconstr. 2020 Dec;13(4):313-328. doi: 10.1177/1943387520952687. Epub 2020 Sep 1.
STUDY DESIGN
Systematic review of hyaluronic acid (HA)-related complications.
OBJECTIVE
To systematically review all available literature including case reports and case series to identify a pattern for the management of vascular compromise resulting in facial skin ischemia and ocular manifestations following HA injection.
METHODS
This review was based on a systematic search of 3 electronic databases PubMed, CINAHL, and Scopus for all available literature including case series and case reports from database inception to July 2019. Only a total of 52 case reports/series were eligible for review and included 107 patients.
RESULTS
The reviewed literature available was comprised from case reports/series and indicated that management of both impending skin necrosis and visual disturbances is variable with no repetitive pattern of action. Yet, successful management is time dependent as early interventions stopped progression and, in some cases, even reversed adverse effects.
CONCLUSION
Results found no universal protocol for achieving optimal results for adverse effects and as such, we present a step-by-step algorithm for the emergency management of complications following HA injection.
研究设计
透明质酸（HA）相关并发症的系统评价。
目的
系统回顾所有可得文献，包括病例报告和病例系列，以确定在透明质酸注射后导致面部皮肤缺血和眼部表现的血管受压情况的处理模式。
方法
本综述基于对3个电子数据库（PubMed、CINAHL和Scopus）的系统检索，以获取从数据库建立到2019年7月的所有可得文献，包括病例系列和病例报告。仅有总共52篇病例报告/系列符合综述标准，纳入了107例患者。
结果
所回顾的可得文献由病例报告/系列组成，表明对即将发生的皮肤坏死和视觉障碍的处理方式各不相同，没有重复的行动模式。然而，成功的处理取决于时间，因为早期干预可阻止病情进展，在某些情况下甚至可逆转不良反应。
结论
研究结果未发现针对不良反应取得最佳效果的通用方案，因此，我们提出了透明质酸注射后并发症应急处理的分步算法。
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