Komplikācijas pēc hialuronskābes un botulīntoksīna injekcijām estētiskajā medicīnā
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Darba mērķis: Pētījuma mērķis ir aprakstīt iespējamas komplikācijas, kas saistītas ar hialuronskābes un botulīna toksīna injekcijām, kā arī sniegt aktuālo informāciju par komplikāciju biežumu atkarībā no speciālista pieredzes, veicot sertificētu Latvijas specialistu aptauju.
Materiāli un metodes: Pētījuma ietvaros tika izveidota strukturēta daudzatbilžu aptauja par komlikāciju biežumu pēc Hialuronskābes/Botulīntoksīna (HA/BTX) injekcijām.
Aptauja tika izveidota, pamatojoties uz literatūras datiem par HA/BTX komplikācijām un to biežumu. Aptaujas anketa tika saskaņota ar Latvijas Estētiskās medicīnas asociācijas valdi un izsūtīta tās biedriem, kas ir sertificēti veikt metodes “M63 Botulīna toksīna pielietojums estētiskajā medicīnā” un “M64 Biomateriālu pielietojums estētiskajā medicīnā”. Tāpat atbilstoši ārsti tika uzrunāti arī individuālā kārtā. Kopumā tika aizpildītas 29 anketas. Respondenti tika iedalīti divās grupās atkarībā no praktizēšanas ilguma, proti, nosacīti pieredzējušos, kas praktizē vismaz 7 gadus, un mazāk pieredzējušos, kas praktizē mazāk par 7 gadiem. Septiņi gadi tika izvēlēts par grupu sadalījumu robežu, jo tā ir praktizēšanas ilguma mediāna, proti, iedala dalībniekus 2 vienlīdzlielās grupās. Mazāk pieredzējušā grupā ārsti vidēji praktizē 3,07 SD=1,77 gadus, savukārt pieredzējušo ārstu grupā 13,27 SD=4,51 gadu, kur SD ir standartdeviācija. Aptaujas rezultāti starp grupām tika salīdzināti, izmantojot neparametriskās statistikas metodes, tajā skaitā, Manna – Vitnija testu. Izmaiņas tika uzskatītas statistiski ticamas, ja p vērtība bija <0,05. Datu apstrādei izmantoja Microsoft Excel 2016 un SPSS Statistics.
Rezultāti: Salīdzinot respondentu atbildes grupu ietvaros konstatēts, ka statistiski nozīmīga atšķirība grupu starpā bija tikai, atbildot uz jautājumu par sāpju biežumu pēc botulīntoksīna injekcijas, kas statistiski ticami biežāk novērota mazāk pieredzējušiem ārstiem (U=64,5 p=0,045). Tāpat grupā, kur ārsti praktizē vismaz 7 gadus, ka ārsti statistiski ticami biežāk veic hialuronskābes injekcijas (U 46,5 p=0,007).
Secinājumi: Sāpes ir biežāk novērotas pēc botulīntoksīna injekcijām mazāk pieredzējušiem ārstiem, iespējams, saistīts ar trūkumiem injekcijas tehnikā, pieredzējušam ārstam vairāk prakses un tehnikas pilnveidošanas iespējas. Atsevišķas retas komplikācijas novēro pieredzējušiem ārstiem - tādas kā bakteriāla infekcija un asinsvadu oklūzija.Tas var būt saistīts ar to, ka, strādājot vairāk un ilgāk, ir lielāka varbūtība sastapties ar retām komplikācijām. Dotajā pētījumā tāpat kā literatūrā biežākas komplikācijas ir sāpes, asinsizplūdums, ne-fluktuējoši mezgliņi.
Pētījuma ierobežojums ir salīdzinoši neliels respondentu skaits, ka arī aptaujām raksturīga atcerēšanas kļūda.(recall bias).
Purpose of the study. The purpose of the study is to describe possible complications associated with the injection of hyaluronic acid and botulinum toxin, as well as provide relevant information on the frequency of complications depending on the experience of the specialist. Materials and methods. The study conducted a structured multivariate study of the frequency of complications after the introduction of hyaluronic acid / botulinum toxin (HA / BTX) The survey was based on literature data on HA and BTX complications and their frequency. The questionnaire was agreed with the Board of the Latvian Association of Aesthetic Medicine and sent to its members, certified by the methods of aesthetic medicine of botulinum toxin M63 and aesthetic medicine of biomaterial M64. A total of 29 questionnaires were completed. Respondents were divided into two groups, depending on the duration of the practice, namely: relatively experienced practitioners at least 7 years old and less experienced practitioners less than 7 years old. Seven years was chosen as the cut-off point for the group, because this is the median of the duration of the practice, that is, the division of participants into 2 groups. In the less experienced group, doctors practice 3.07 SD = an average of 1.77 years, while in the more experienced group 13.27 SD = 4.51 years, where SD is the standard deviation. The survey results were compared between groups using nonparametric statistical methods, including the Mann-Whitney test. Changes were considered statistically significant if the p value was <0.05. Microsoft Excel 2016 and SPSS Statistics were used to process data. Results: A comparison of respondents within groups showed that there was a statistically significant difference between groups only in answering the question of the frequency of pain after botulinum toxin injection, which was statistically significantly more common among less experienced doctors (U = 64.5 p = 0.045). Similarly, in a group of doctors who have been practicing for at least 7 years, doctors are also statistically significantly more likely to inject hyaluronic acid (U46.5,p=0.007). Conclusions: pain is more often observed after injections of BTX by less experienced doctors, possibly due to deficiencies in the injection technique, more experience, and the possibility of developing the technique for an experienced doctor. Experienced doctors experience some rare complications, such as bacterial infection and vascular obstruction. This may be due to the fact that the more you work, the greater the possibility that you will experience complications. Compared to published data, there are more common complications, such as pain, bruising, and unsteady nodules. The disadvantage of the study is the relatively small number of respondents and questionnare can exist a recall bias.
Purpose of the study. The purpose of the study is to describe possible complications associated with the injection of hyaluronic acid and botulinum toxin, as well as provide relevant information on the frequency of complications depending on the experience of the specialist. Materials and methods. The study conducted a structured multivariate study of the frequency of complications after the introduction of hyaluronic acid / botulinum toxin (HA / BTX) The survey was based on literature data on HA and BTX complications and their frequency. The questionnaire was agreed with the Board of the Latvian Association of Aesthetic Medicine and sent to its members, certified by the methods of aesthetic medicine of botulinum toxin M63 and aesthetic medicine of biomaterial M64. A total of 29 questionnaires were completed. Respondents were divided into two groups, depending on the duration of the practice, namely: relatively experienced practitioners at least 7 years old and less experienced practitioners less than 7 years old. Seven years was chosen as the cut-off point for the group, because this is the median of the duration of the practice, that is, the division of participants into 2 groups. In the less experienced group, doctors practice 3.07 SD = an average of 1.77 years, while in the more experienced group 13.27 SD = 4.51 years, where SD is the standard deviation. The survey results were compared between groups using nonparametric statistical methods, including the Mann-Whitney test. Changes were considered statistically significant if the p value was <0.05. Microsoft Excel 2016 and SPSS Statistics were used to process data. Results: A comparison of respondents within groups showed that there was a statistically significant difference between groups only in answering the question of the frequency of pain after botulinum toxin injection, which was statistically significantly more common among less experienced doctors (U = 64.5 p = 0.045). Similarly, in a group of doctors who have been practicing for at least 7 years, doctors are also statistically significantly more likely to inject hyaluronic acid (U46.5,p=0.007). Conclusions: pain is more often observed after injections of BTX by less experienced doctors, possibly due to deficiencies in the injection technique, more experience, and the possibility of developing the technique for an experienced doctor. Experienced doctors experience some rare complications, such as bacterial infection and vascular obstruction. This may be due to the fact that the more you work, the greater the possibility that you will experience complications. Compared to published data, there are more common complications, such as pain, bruising, and unsteady nodules. The disadvantage of the study is the relatively small number of respondents and questionnare can exist a recall bias.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Hialuronskābe, botulīntoksīns, inkekcijas, komplikācijas., hyaluronic acid, botulinum toxin, infections, complications.