A型肉毒毒素用于缓解假体隆乳术后疼痛及降低包膜挛缩的疗效及安全性分析  

Efficacy and safety of BTX-A in alleviating postoperative pain and reducing capsular contracture after breast augmentation surgery

作　　者：荆冲 王晓朋 肖征刚 Jing Chong;Wang Xiaopeng;Xiao Zhenggang(Department of Cosmetic Plastic Surgery,Changsha YaMei Medical Cosmetic Hospital,Changsha 410000,China)

机构地区：[1]长沙雅美医疗美容医院美容整形外科,长沙410000

出　　处：《中华医学美学美容杂志》2025年第2期167-171,共5页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨A型肉毒毒素(BTX-A)用于缓解假体隆乳术后疼痛及降低包膜挛缩的疗效及安全性。方法本研究为单中心、双盲、随机对照试验,前瞻性纳入2020年5月至2021年1月长沙雅美医疗美容医院212例接受假体隆乳术的女性患者。根据隆乳术中是否使用BTX-A注射胸大肌将患者分为两组:BTX-A组106例,年龄(33.1±3.8)岁;对照组106例,年龄(33.3±3.5)岁。采用视觉模拟量表(VAS)评分评估患者术后第1、3、7天疼痛程度。术后随访2年,比较2组患者术后VAS评分、疼痛持续时间、包膜挛缩率及不良反应发生率。结果BTX-A组和对照组各失访1例。BTX-A组术后第1、3天VAS评分为(3.93±1.77)、(5.35±2.04)分,低于对照组的(5.93±2.17)、(7.34±1.75)分(均P<0.001);术后第7天BTX-A组和对照组VAS评分为(1.96±1.71)、(2.26±1.90)分,差异无统计学意义(P=0.225)。两组的疼痛程度均呈现先加重后减轻的趋势,差异有统计学意义(P<0.001)。BTX-A组疼痛持续时间为(2.6±1.8)d,短于对照组的(4.9±2.1)d,差异有统计学意义(P<0.001)。BTX-A组包膜挛缩率为0.95%(1/105),对照组为1.90%(2/105),差异无统计学意义(P=1.000)。BTX-A组不良反应发生率为11.32%(12/106),对照组为10.38%(11/106),差异无统计学意义(P=0.825)。2组均无呼吸、心血管意外等严重不良反应及死亡病例。结论BTX-A可以缓解假体隆乳术后疼痛程度,安全性高。但在预防包膜挛缩发生方面无明显优势。Objective To explore the efficacy and safety of type A botulinum toxin(BTX-A)in alleviating pain and reducing capsular contracture after breast augmentation surgery.Methods This single-center,double-blind,and randomized controlled trial included 212 female patients who underwent breast augmentation surgery at Changsha YaMei Medical Cosmetic Hospital from May 2020 to January 2021.Patients were divided into two groups according to whether BTX-A was injected into the pectoralis major during the augmentation:106 in the BTX-A group,with an average age of(33.1±3.8)years;and 106 in the control group,with an average age of(33.3±3.5)years.The visual analogue scale(VAS)was used to assess pain on days 1,3 and 7 post-operation.After two years of follow-up,the postoperative VAS scores,duration of pain,rates of capsular contracture,and incidence of adverse reactions were compared between the two groups.Results One case was lost to follow-up in each group.On postoperative days 1 and 3,the VAS scores of the BTX-A group were(3.93±1.77)and(5.35±2.04)scores,respectively,lower than those of the control group,which were(5.93±2.17)and(7.34±1.75)scores(both P<0.001).On day 7,the scores were(1.96±1.71)and(2.26±1.90)scores,respectively,with no statistically significant difference(P=0.225).The pain severity in both groups showed a trend of initial increase followed by a decrease,with a significant difference(P<0.001).The duration of pain in the BTX-A group was(2.6±1.8)days,shorter than that in the control group(4.9±2.1)days,with a statistically significant difference(P<0.001).The rate of capsular contracture in the BTX-A group was 0.95%(1/105),compared to 1.90%(2/105)in the control group,with no statistically significant difference(P=1.000).The incidence of adverse reactions was 11.32%(12/106)in the BTX-A group and 10.38%(11/106)in the control group,with no statistically significant difference(P=0.825).There were no severe adverse reactions such as respiratory or cardiovascular events or deaths in either group.Conclusion BTX-A c

关 键 词：隆乳术 A型肉毒毒素 疼痛 包膜挛缩 胸大肌 

分 类 号：R655.8[医药卫生—外科学]