本文選題：玻尿酸 + 隆鼻��； 參考：《昆明醫(yī)科大學》2017年碩士論文

【摘要】：[目的]1.探討玻尿酸隆鼻致血管栓塞后玻璃酸酶的使用時間與治療效果的關(guān)系;2.探討高壓氧治療的應(yīng)用與玻尿酸隆鼻致血管栓塞治療效果的關(guān)系。[方法]本研究包括臨床部分和基礎(chǔ)部分兩部分,第一部分為臨床部分,選用2015年9月至2016年11月收住于昆明醫(yī)科大學第二附屬醫(yī)院整形外科住院部以鼻部感染為主要診斷、玻尿酸隆鼻后鼻部不適為主訴的8例患者為研究對象。對每位患者進行玻璃酸酶局部注射、高壓氧及支持治療。第二部分為基礎(chǔ)部分,2016年12月至2017年2月,選用成年雌性伊拉兔24只,兔耳共48只,建立兔耳耳郭中動脈玻尿酸栓塞模型。兔耳分組,1組為對照組;2、3、4、5組分別為兔耳耳郭中動脈玻尿酸栓塞模型建立后4h、8h、24h和48h注射玻璃酸酶治療組;6組為高壓氧治療組。于兔耳耳郭中動脈玻尿酸栓塞模型建立后第1天、第7天和第14天進行兔耳影像、背側(cè)溫度和末端血氧飽和度的采集,于第14天進行兔耳壞死組織面積和組織學標本采集,將數(shù)據(jù)進行統(tǒng)計分析。[結(jié)果]臨床部分,8例玻尿酸隆鼻致血管栓塞患者痊愈出院,部分患者遺留瘢痕�；A(chǔ)部分,兔耳耳郭中動脈玻尿酸栓塞模型建立后第14天各實驗組的兔耳壞死面積具有統(tǒng)計學差異(P0. 05);所有實驗組的兔耳壞死面積具有增長趨勢;4組與5組兔耳壞死面積差異無統(tǒng)計學意義;1組與其他5組兔耳壞死面積均有統(tǒng)計學差異(P0. 05)。[結(jié)論]玻尿酸隆鼻致血管栓塞發(fā)病48小時之內(nèi)予以玻璃酸酶局部注射可取得明顯療效,越早使用療效越好。高壓氧治療玻尿酸隆鼻致血管栓塞的效果可靠,臨床可作為常規(guī)輔助治療方法之一。
[Abstract]:[objective] 1. To investigate the relationship between the time of hyaluronidase use and the therapeutic effect after embolization induced by hyaluronic acid rhinoplasty. To explore the relationship between the application of hyperbaric oxygen therapy and the effect of vascular embolization induced by hyaluronic acid augmentation nose. [methods] this study includes two parts: clinical part and basic part. The first part is clinical part. The inpatient department of plastic surgery in the second affiliated Hospital of Kunming Medical University from September 2015 to November 2016 was selected as the main diagnosis of nasal infection. Eight patients with nasal discomfort caused by hyaluronic acid augmentation rhinoplasty were studied. Each patient was given local hyaluronidase injection, hyperbaric oxygen and supportive therapy. The second part is the basic part. From December 2016 to February 2017, 24 adult female rabbits and 48 rabbit ears were selected to establish the model of hyaluronic acid embolization in the middle auricle of rabbits. Rabbit ears were divided into two groups: control group (n = 5): the middle auricle artery hyaluronic acid embolization model was established at 4 h, 8 h, 24 h and 48 h after injection of hyaluronidase respectively, the 6 groups were treated with hyperbaric oxygen. On day 1, day 7 and day 14 after the establishment of the model of hyaluronic acid embolization in the middle ear of rabbit ear, the images of rabbit ear were collected, the temperature of the dorsal side and the blood oxygen saturation at the end of the ear were collected, and the necrotic tissue area and histological specimens of the ear were collected on the 14th day. Make statistical analysis of the data. Results: 8 patients with vascular embolism caused by hyaluronic acid augmentation rhinoplasty were cured and some patients left scar. On the 14th day after the establishment of hyaluronic acid embolization model of the middle ear artery of rabbit ear, the necrotic area of each experimental group had statistical difference (P 0. 0). There was no significant difference in necrosis area between group 4 and group 5. There was no significant difference in necrosis area between group 1 and other 5 groups (P 0. 0). 05. [conclusion] Local injection of hyaluronidase is effective within 48 hours of embolism caused by hyaluronic acid augmentation rhinoplasty, and the earlier it is used, the better the effect is. Hyperbaric oxygen (HBO) is an effective and reliable method in treating vascular embolism caused by hyaluronic acid augmentation rhinoplasty and can be used as a routine adjuvant therapy.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R62

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