本例人工材料注射隆乳后迟发型炎症反应是由2019新型冠状病毒感染引起的吗?1例报道并文献回顾  

Is this delayed inflammatory reaction of breast polyacrylamide hydrogel caused by 2019-nCoV infection?A case report and literature review

作　　者：马小睦 徐伯扬 刘温悦 栾杰 刘春军 Ma Xiaomu;Xu Boyang;Liu Wenyue;Luan Jie;Liu Chunjun(Department of Breast Comprehensive Plastic Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院乳腺综合整形科,北京100144

出　　处：《中华整形外科杂志》2024年第2期212-217,共6页Chinese Journal of Plastic Surgery

基　　金：国家临床重点专科建设项目(1112621048)。

摘　　要：使用聚丙烯酰胺水凝胶(PAHG)进行隆乳手术曾在中国十分流行。该文报道了1例PAHG隆乳20年后,无其他诱因于2019新型冠状病毒(2019-nCoV)感染后出现单侧乳房迟发型炎症反应的患者。患者女,45岁,在2019-nCoV感染3周后出现右侧乳房明显红肿热痛,范围上至锁骨、下至上腹部,考虑诊断为病毒感染伴发乳房迟发型炎症反应。急诊手术术中发现PAHG呈黄绿色、稀糊状涌出,腐臭味明显,存在大量组织坏死糜烂及脓液,创面广泛弥漫性渗血,术中血红蛋白下降明显。术后无并发症,于术后1周出院。2019-nCoV对人体异物及免疫系统的影响还有很多未知区域,可能会引起凶险的迟发型炎症反应,如该例中的电解质紊乱、大量失血及可能发生的感染性休克,在临床中需引起足够重视、给予及时干预。报道各种可能出现的症状和机制有利于提高整形外科医生的认识水平、加强对填充材料使用的谨慎程度。Breast augmentation using polyacrylamide hydrogel(PAHG)was widely used in China.We present the first case of delayed breast inflammation after 2019 novel coronavirus(2019-nCoV)infection in a patient who recieved breast augmentation with PAHG 20 years ago,without any other predispositions.The 45-year-old female patient complained of severe breast swelling and pain three weeks after 2019-nCoV infection.The swelling extended from the upper clavicle to the upper abdomen.Delayed inflammation reaction was diagnosed,followed by emergency surgery.During the surgery,the injected material was observed to gush out in a form of greenish and thin paste,with a foul odor.The wound had extensive diffuse oozing and hemoglobin decreased significantly.The patient was discharged one week after surgery.During a three-month follow-up,she experienced weakness and fatigue with no complications.There are still many unknown areas of the impact of 2019-nCoV on human foreign bodies and immune system,which is diverse and complex.Reporting various possible symptoms and mechanisms is conducive to improving the level of awareness and intervention of plastic surgeons.

关 键 词：隆乳术 2019新型冠状病毒 聚丙烯酰胺水凝胶 迟发型炎症反应 

分 类 号：R655.8[医药卫生—外科学]