Silicone Fluid-Induced Pulmonary Emboli: A Case Report

矽膠液注射引發肺栓塞之病例報告

曾若琦(Jo-Chi Tseng) ； 花仲涇(Chung-Ching Hua) ； 謝文斌(Wen-Bin Shieh) ； 張良慈(Liang-Che Chang)

《胸腔醫學》 17卷3期 (2002/09) Pp. 271-275

摘要

矽膠因為有穩定的物理及耐熱特性，而且被認為具有低免疫刺激性及最少的組織反應度。因此在臨床上被使用於人體皮下組織脂肪的填充，如隆乳及其它美容性用途。但經過數十年的應用，有許多併發症已被報告，包括局部的及全身系統的反應，如肉芽腫，硬化症，類結締組織症候群。對肺部的影響，有使用矽膠隆乳數年後，產生纖維性變化的報告。回顧文獻，僅有少數的報告是因局部液態矽膠注射後引發之急性肺炎，急性呼吸窘迫症候群，或肺栓塞的病例。目前國內使用液態矽膠局部注射隆乳已被禁止。但仍有少數小針美容的非法醫療行為時有所聞。我們報告一位三十歲女性，進行局部胸部隆乳液態矽膠注射後，引發肺栓塞及廣泛性肺泡出血。以類固體治療後，症狀獲得改善。在八個月後追蹤，肺功能及胸部X光，恢復正常，無明顯併發症產生。

關鍵字

液態矽膠 ； 肺栓塞

並列摘要

Silicone fluid is a good substitute for human subcutaneous fat, but has been associated with many complications, including local tissue granulomatous reaction, systemic sclerosis, connective tissue disease-like syndromes, granulomatous hepatitis, and systemic involvement. It is a well-known illegal procedure for mammary augmentation in Taiwan. Pulmonary involvement in human beings has been reported in a few cases, and presents as acute pneumonitis, pulmonary emboli, and acute respiratory distress syndrome after the silicone injection. We report a 30-year-old previously healthy female who received a silicone fluid injection for mammary augmentation and developed an acute onset of cough, hemoptysis, and progressive dyspnea. Pulmonary embolism was diagnosed from the histopathology of lung tissue obtained from a wedge biopsy, which revealed variably-sized vacuoles within the pulmonary vessels, alveolar septal capillaries and intra-alveolar spaces, extensive intra-alveolar hemorrhage, and a few foamy histocytes infiltrating into the alveolar spaces. After steroid treatment, the patient gradually improved. One month after the silicone fluid injection, the pulmonary function test showed a moderate reduction in the diffusing capacity. The patient had reached a nearly complete recovery without any lung sequence as determined by a follow-up chest roentgenogram and the normal pulmonary function test after eight months.

並列關鍵字

silicone fluid ； pulmonary emboli