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注射性软组织填充剂：暂时性制剂

Authors
Alastair Carruthers, FRCPC
Jean Carruthers, MD, FRCSC
Shannon Humphrey, MD, FRCPC, FAAD
Section Editors
Jeffrey S Dover, MD, FRCPC
Charles E Butler, MD, FACS
Deputy Editor
Abena O Ofori, MD
Translators
葛一平, 主治医师

引言

软组织填充剂可单独使用或与其他美容操作联合使用，以进行除皱和修复由衰老、脂肪萎缩或其他原因造成的组织体积丢失。与无限期存留于组织中的永久性填充剂不同，暂时性填充剂最终会被人体再吸收。某些产品(如注射用胶原和透明质酸)，主要通过体积填充效果发挥作用。其他产品[包括羟磷灰石钙和聚左旋乳酸(poly-L-lactic acid, PLLA)填充剂]，则作为内源性胶原形成的支架发挥作用。

要治疗的皮肤缺陷类型及期望的作用持续时间，会影响对软组织填充剂的选择(表 1)。无论选择哪种填充剂，临床医生对所用产品的熟悉程度都至关重要；不正确的注射技术可导致不良美容结局并增加不良反应的发生率。虽然某些不良反应会随着时间推移而自行消退，但其他不良反应(如组织坏死)可能导致永久性后遗症，如瘢痕。

本文将总结几类生物降解型软组织填充剂的特点、有效性和不良反应。软组织填充剂的临床使用原则和并发症的概述，以及永久性软组织填充剂的相关内容，参见其他专题。 (参见“注射性软组织填充剂：永久性填充剂”和“注射性软组织填充剂：临床应用概述”)

透明质酸

透明质酸是一种天然糖胺聚糖，为真皮细胞外基质的主要成分。这些分子在维持皮肤结构和功能方面发挥着关键作用，同时其与水分高度结合的能力对维持皮肤湿润是有价值的[1]。

向皮肤中注射外源性透明质酸，可有效改善组织体积丢失引起的皮肤外观不佳，同时治疗后还可提供一种自然的外观和触感。这些特点加上发生不良反应的风险相对较低，使得含有透明质酸的填充剂已经成为世界上最常用的注射用软组织填充剂(表 1)[2]。虽然美国食品药品监督局(Food and Drug Administration, FDA)仅批准将透明质酸填充剂用于治疗鼻唇沟，但这些产品已被用于各种其他适应证，包括木偶纹、眉间纹、年龄相关性手背体积丢失，以及唇部、颏和颊部的填充[3-5]。治疗的临床疗效一般持续6-12个月(表 1)[6]。

                         

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-19.
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