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高压氧在填充剂诱导的血管闭塞中的作用。

Role of Hyperbaric Oxygen in Filler-Induced Vascular Occlusion.

机构信息

Critical Care Unit, Provincial Hospital of Castellon, Castellón de la Plana, Spain.

Hyperbaric Therapy Unit, General Hospital of Castellon, Castellón de la Plana, Spain.

出版信息

Aesthetic Plast Surg. 2024 Jul;48(14):2713-2721. doi: 10.1007/s00266-024-03920-7. Epub 2024 Mar 8.

Abstract

INTRODUCTION

The rising incidence of filler-induced vascular complications in the context of aesthetic procedures necessitates a thorough assessment of therapeutic options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential intervention for filler-induced vascular occlusion (FIVO), although optimal dosing and timing remain undefined.

METHODS

This review explores the pathophysiology of FIVO and elucidates HBOT's multifaceted role in salvaging ischemic tissue. The physical and biochemical mechanisms of HBOT, including its vasodilatory, anti-spasmodic, and anti-inflammatory effects, are examined.

RESULTS

HBOT serves as an adjunctive therapy in FIVO management, emphasizing timely intervention, adherence to specific pressures (two atmosphere absolute), and session durations (60 minutes) to optimize efficacy and minimize complications. While existing HBOT protocols for compromised grafts provide insights, standardized guidelines for FIVO are lacking.

CONCLUSION

HBOT enhances tissue oxygenation, modulates reactive oxygen species, and influences angiogenesis and hypoxia response. However, it does not replace key treatment protocols for filler vascular complications. Further research and standardized protocols are warranted to define HBOT's definitive role in mitigating filler-induced vascular complications. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

简介

在美容手术的背景下,填充物引起的血管并发症的发病率不断上升,这就需要对治疗方案进行全面评估。高压氧治疗(HBOT)已成为治疗填充物引起的血管闭塞(FIVO)的一种潜在干预手段,尽管最佳剂量和时间仍未确定。

方法

本综述探讨了 FIVO 的病理生理学,并阐明了 HBOT 在挽救缺血组织方面的多方面作用。HBOT 的物理和生化机制,包括其血管扩张、抗痉挛和抗炎作用,都进行了研究。

结果

HBOT 是 FIVO 管理的辅助治疗方法,强调及时干预、遵循特定压力(绝对两大气压)和治疗时间(60 分钟),以优化疗效并最小化并发症。虽然现有的用于受损移植物的 HBOT 方案提供了一些见解,但 FIVO 的标准化指南仍缺乏。

结论

HBOT 可增强组织氧合作用,调节活性氧物质,并影响血管生成和缺氧反应。然而,它并不能替代填充物血管并发症的关键治疗方案。需要进一步的研究和标准化方案来确定 HBOT 在减轻填充物引起的血管并发症方面的明确作用。

证据等级 IV 本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

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