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透明质酸填充剂致血管阻塞——三例报告及防治概述。

Hyaluronic acid filler-induced vascular occlusion-Three case reports and overview of prevention and treatment.

机构信息

Plastic Surgery Institute of Weifang Medical University, Weifang, China.

School of Qingdao University, Qingdao, China.

出版信息

J Cosmet Dermatol. 2024 Apr;23(4):1217-1223. doi: 10.1111/jocd.16147. Epub 2023 Dec 22.

Abstract

BACKGROUND

Vascular occlusion induced by hyaluronic acid injections is rare, but can lead to severe adverse events, including necrosis, blindness, and cerebral infarction.

OBJECTIVE

This study aims to explore methods of reducing the risk of complications such as embolism induced by hyaluronic acid injection, and to study the impact of comprehensive systematic treatment on the prognosis of patients with hyaluronic acid embolism.

METHODS

The clinical data of three female patients with vascular occlusion due to hyaluronic acid injection was analyzed. Their median age was 26 years, with symptoms presenting 1-6 h postinjection. Hospital stays averaged 6 days. Two patients had ptosis, diplopia, and severe pain after injection of eyebrows. The other, who had a nose enhancement, experienced facial skin color changes and intense pain.

RESULTS

Two patients received comprehensive, systematic treatment based on injectable hyaluronidase. One patient self-discharged after receiving injectable hyaluronidase, antispasmodic, and vasodilator treatment on the night of embolism and returned to the hospital 3 days later with worsening embolism symptoms and received symptomatic treatment again. Two patients who received comprehensive, systematic treatment based on injectable hyaluronidase showed significant improvement, while the patient who did not undergo systematic treatment left scars on the face.

CONCLUSION

Vascular occlusion caused by hyaluronic acid facial filling is a severe adverse event, and timely, comprehensive, systematic treatment can effectively improve irreversible damage caused by thrombosis, and even cure it.

摘要

背景

透明质酸注射引起的血管闭塞很少见,但可导致严重的不良事件,包括坏死、失明和脑梗死。

目的

本研究旨在探讨降低透明质酸注射引起的栓塞等并发症风险的方法,并研究综合系统治疗对透明质酸栓塞患者预后的影响。

方法

分析了 3 例因透明质酸注射导致血管闭塞的女性患者的临床资料。她们的中位年龄为 26 岁,症状在注射后 1-6 小时出现。平均住院时间为 6 天。2 名患者在眉部注射后出现上睑下垂、复视和严重疼痛,另一名患者在鼻部注射后出现面部皮肤变色和剧烈疼痛。

结果

2 名患者接受了基于注射用透明质酸酶的综合系统治疗。1 名患者在栓塞当晚接受了注射用透明质酸酶、抗痉挛和血管扩张剂治疗后自行出院,3 天后因栓塞症状加重再次返回医院,并再次接受对症治疗。2 名患者接受了基于注射用透明质酸酶的综合系统治疗后明显好转,而未接受系统治疗的患者面部留下了疤痕。

结论

透明质酸面部填充引起的血管闭塞是一种严重的不良事件,及时、全面、系统的治疗可以有效改善血栓引起的不可逆损伤,甚至治愈。

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