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目的:观察经皮面动脉透明质酸酶注射治疗面部注射美容术后出现局部血运障碍、皮肤破溃、坏死等并发症的临床效果。方法:回顾性选取解放军总医院第四医学中心2019年1月至2020年5月收治的面部透明质酸注射美容术后注射物进入血管致局部血运障碍、皮肤破溃、坏死，予经皮面动脉注射透明质酸酶治疗的患者。注射时以动脉采血针或一次性使用静脉输液针经皮面动脉穿刺，针体与皮肤夹角一般为30°～45°，穿刺成功后将透明质酸酶溶液(1 000 U/ml)缓慢推注入面动脉，用量范围在0.5～1.5 ml。术后观察患者产生皮肤轻松感、触痛缓解、溃疡愈合、创面恢复时间。术后3～12个月观察皮损部位色素沉着情况，并采用温哥华瘢痕量表(VSS)进行瘢痕评分。结果:该研究共纳入13例患者，男1例，女12例，年龄18～45岁，平均35岁。发病至就诊时间为14 h至4 d,平均时间2.5 d。注射物质均为透明质酸，注射部位：鼻唇沟区7例，鼻根部3例，前额区2例，上唇1例。临床表现：局部皮肤青紫、肿胀、破溃、结痂样改变，部分伴口腔溃疡。经皮面动脉透明质酸酶注射后局部皮肤软组织损伤均及时得到改善，患者产生皮肤轻松感时间为(0.77±0.25) d、触痛缓解时间为(1.23±0.64) d、溃疡愈合时间为(3.14±0.64) d、创面恢复时间为(5.85±0.86) d。随访3～12个月，平均7个月，1例患者存在轻微瘢痕及色素沉着，VSS评分为1分，2例患者仅有轻度色素沉着，VSS评分均为0分，其余10例均无瘢痕及色素沉着，VSS评分均为0分。所有患者未出现头疼、头晕等症状，无颅内梗死、颅内出血及视力受损情况出现，治疗效果满意。结论:在面部注射美容术后出现皮肤损伤的处理过程中，及时经皮面动脉注射透明质酸酶对改善局部微循环、减轻软组织损伤明确有效。“,”Objective:To analyze the clinical effect of hyaluronidase injection through the facial artery in the treatment of vascular embolism such as skin ulceration and necrosis after cosmetic injection.Methods:Hyaluronidase was injected through facial artery in 13 patients who were diagnosed with vascular embolism after facial injection from January 2019 to May 2020. The facial artery was punctured with 22-gauge arterial blood collection needle or 19/23-gauge disposable venous infusion needle. The angle between the needle body and the skin varies depending on the patients’ weight, ranged 30°-45°. The needle was advanced slowly and pushed forward by 2-3 mm when blood backflow appeared in the needle core. After confirming the successful puncture of the facial artery, 0.5-1.5 ml hyaluronidase was slowly injected into the facial artery. The time of skin relaxation, tenderness relief, ulcer healing and wound recovery were observed. The pigmentation was observed and the Vancouver Scar Scale (VSS) was used to score the scars after 3-12 months.Results:A toal of 13 patients with vascular complications of hyaluronidase filler were retrospectively reviewed. The patients were 18-45-year-old(mean age, 35 years) and received hyaluronidase filler at private clinics. There were 12 women and 1 man. The time from onset to visit was 14 h to 4 d, with an average time of 2.5 d. Hyaluronidase was most commonly injected into the nasolabial folds (54%, 7 of 13). The second-ranked area is the nasalroot (23%, 3 of 13). These patients had skin swelling, necrosis, ecchymosis or black scabs during or after hyaluronidase injection. Some patients showed skin lesions combined with oral ulcer. After percutaneous facial arterial hyaluronidase injection, the local skin tissue injuries of the 13 patients were improved in time. The time of skin relaxation was (0.77±0.25) d, the time of tenderness relief was (1.23±0.64) d, the time of ulcer healing was (3.14±0.64) d and the time of wound recovery was (5.85±0.86) d. Patients were followed up for 3-12 months, with an average of 7 months. One patient had slight scar (VSS score of 1), two patients had only mild pigmentation (VSS score of 0), and the other ten patients had no scar and pigmentation (VSS score of 0).Conclusions:It is effective to improve local microcirculation and reduce skin tissue injury after percutaneous facial artery hyaluronidase injection in the treatment of skin injury caused by facial filler injection.