【作者】 方彰林； 孙瑛； 汪立川； 高红云； 奚廷斐；

【Author】 FANG Zhang-lin SUN Ying XI Ting-fei.(Beijing Huangsi Aesthetic Plastic Surgery Hospital,Beijing 100011,China)

【机构】 北京黄寺美容外科医院； 中国药品生物制品检定所；

【摘要】 目的比较6种隆乳材料生物相容性和安全性。方法以12只 Beagle 犬为研究对象,通过陋染色、Van -Gieson 染色,比较交联透明质酸钠假体(CSHP)、非交联透明质酸钠假体(NCSHP)、甲基纤维素假体(CMCP)、硅凝胶假体(SGP)、亲水性聚丙烯酰胺凝胶假体合格(HPAGP)、注射用聚丙烯酰胺凝胶(IHPAG)所致机体局部组织反应的强弱程度。结果 6种材料引起的早期(术后14,30天)组织反应表现为：NCSHP、CMCP、HPAGP 周围炎症反应最重；CSHP、SGP 次之,IHPAG 最轻微。30天后,6种材料周围均形成纤维包囊,但构成纤维膜的成分及其排列随材料不同而异,且随时间推移,各材料周围纤维包膜囊的结构及排列均发生不同程度的变化。NCSHP、CMCP、HPAGP 的包膜有明显收缩倾向,并在2年后均发生不同程度挛缩。CSHP、SGP 未见明显挛缩倾向,2年后,纤维包膜仍较薄并有弹性。JHPAG 的包膜2年后仍松软而有弹性。结论 SGP 作为一种较为成熟的隆乳材料,生物相容性及美容效果均是目前较为理想的材料；CSHP 的生物相容性虽较好,但美容效果相对较差,且存在渗漏问题,需对材料进一步改进；IHPAG 引起的炎症反应轻微,生物相容性好,具有应用前景,但若注射层次掌握不好,材料易被纤维组织分割,影响美容效果,因此在临床应用中,要熟练掌握注射技,NCSHP、CMCP、HPAGP 生物相容性及美容效果均较差,且存在严重渗漏,故目前暂不适宜用作隆乳材料。更多还原

【Abstract】 Objective To compare biocompatibility and safety of six implantation prosthesis.Methods Subcutaneous implantation of crosslinked sodium hyaluronate prosthesis(CSHP),silica gel prosthesis(SOP),non-crosslinked sodium hyalurorate prosthesis(NCSHP),carboxy methycel prosthesis(CMCP),hydrophilic polyacrylamide gel prosthesis (HPAGP),injectable hydrophilic polyacrylamide gel(IHPAG)was performed in 12 beagle dogs.Local reaction of sur- rounding tissues of the transplants were observed with HE and Van-Gieson stains after the transplantation at 14,30 and 90 days,6 months,and 1 and 2 years.Results The most serious reaction was observed in NCSHP,CMCP and HPAGP, moderate reaction in CSHP and SGP and mild reaction in IHPAG.Van-Gieson staining showed that collagenous fibrous capsule around implanted prosthesis was formed from 30 days to 2 year.The component and arrangment of the capsule were different among the defferent prosthesis,but changed with time.Shrinkage of the capsules was found in NCSHP,CMCP and HPAGP,and contraction occurred two years later.The capsules formed by CSHP and SGP had no contraction after two-year implantation.IHPAG capsule was still soft and elastic after 2 years.Conclusion SGP is one of the best material for breast enlargement with a good biocompatobility and soft capsule.IHPAG is a new filling material with mild inflamma- tory reaction and thinner and softer capsule.CSHP should be improved further because its molding effec is not gratified. Both the biocompatibility and molding effect of NCSHP,CMCP and HPAGP are not gratified and further modification is needed.更多还原