有些人为了变美能有多拼？

光靠P图还不够！

这些年轻人

相继自己动手做医美

把自己弄到“面目全非”

紧急入院

做出改变，需要勇气

但是稍有不慎

可能会付出巨大代价

一周内两个小姑娘“面目全非”！

小田今年22岁，她最大的烦恼就是脸上总是“爆痘”，十分影响颜值。一天，小田在网络平台上看到有博主种草“微针祛痘”法，只需DIY，皮肤就能恢复光洁。她非常动心，对自己“痛下狠手”。

本以为是变美的开始，没想到现实却是：打完针半小时后，小田的额面部突然水肿，肿成“猪头”，连睁眼都困难。这可把她吓得不轻，赶紧到医院就诊。

医生看诊后发现，小田这是“微针祛痘”不当导致的“获得性血管性水肿、荨麻疹”。

由于症状比较严重，有并发过敏性休克的可能，医生决定将其收治入院治疗。“以后再也不敢自己弄了。”小田心有余悸。

小美（化名）是一名公司员工，也是一名溶脂针爱好者。这天休息，小美自行在家注射网购的溶脂针。这已经不是她第一次注射了，但这回注射后，她的面颈部很快就发生了水肿，痛得碰也不敢碰，而且喉咙感到肿胀、瘙痒。

接诊后，医生发现，她是典型的“过敏反应、获得性血管性水肿、荨麻疹”，罪魁祸首就是她在家注射的溶脂针。之后，小美被收治入院，经过系列治疗后，终于恢复健康。

医生表示，像这样自己家做医美或者去不正规场所做医美引起的面部“过敏反应”和“获得性血管性水肿”甚至过敏性休克的患者，并不少见，大多是因为不详的“医美药品”引起的，还有就是不正规的操作。

值得一提的是，“获得性血管性水肿”通常会并发荨麻疹，如伴发喉头水肿可造成呼吸困难，甚至窒息死亡；消化道受累时可有腹痛、腹泻等表现。医生表示，一旦发生此类病情，一定要及时治疗。

为了减肥

女孩自己注射1mg司美格鲁肽后送医抢救

日常门诊中，浙江省人民医院内分泌科副主任医师黄青华经常会遇到一些想减肥的患者，要求开司美格鲁肽。

“我们遇到过一些患者，自行通过一些渠道购买药物后自行注射，最后出现问题。” 黄青华说。

曾经有20多岁的女孩，买了司美格鲁肽后，为了追求减肥效果，直接注射1mg，出现剧烈的恶心、呕吐，一度呕吐到脱水，被紧急送到医院急诊室抢救。

“在国内，司美格鲁肽的适应症是血糖控制不佳或者有心血管疾病的成人2型糖尿病患者，作为处方药，在使用前，我们是要对患者进行相关检查。”

这样的检查包括血糖、血脂、血尿酸、血压、糖化血红蛋白、肝肾功能、胰岛功能、胰腺炎检测、降钙素、肥胖相关激素、心电图以及甲状腺和肝脏B超等。

黄青华解释，司美格鲁肽注射后，药物主要是通过肝肾代谢，所以要检查肝肾功能是否正常，以免出现不良后果。产期注射司美格鲁肽会增加胰腺炎和甲状腺髓样癌的风险，所以我们需要排查药物禁忌。司美格鲁肽也可能会引起心率、血压异常，因此需要进行心率血压评估。肥胖人群我们也需要检查肥胖相关激素排查继发性肥胖及肥胖导致的代谢紊乱。

实际上，司美格鲁肽的使用注射要循序渐进，逐渐加量。

“临床上，如果患者具有适应症，第一次，我们一般注射0.25mg 一周一次，看患者在一周内是否有恶心呕吐等胃肠道反应，以及降糖减重效果，如果反应不明显可逐渐增加到0.5mg 一周一次，一般剂量可以打到1mg 一周一次。如果是减重，一般达到理想的体重或者处于体重瓶颈期了，就可以停止注射；但它本身时一个降糖药物，糖尿病患者是可以长期使用的。” 黄青华表示。

作为药物，

司美格鲁肽虽然减重效果可喜，但也伴随着相应的副作用：恶心、呕吐、腹泻等肠胃不适，另外，动物试验中发现司美格鲁肽会刺激甲状腺C细胞增生，所以该药禁用于有甲状腺髓样癌的患者，同时因为会诱发胰腺癌等，甘油三酯高的人群也不建议使用。

“一些年轻女孩本身挺瘦的，但为了追求上镜等效果，也会提出打针，这些我们都是拒绝的。”作为内分泌科医生，黄青华不建议患者自行购药、自行使用，“一定要到医院，经过专业医生的评估。”

今年初初，司美格鲁肽出现口服型，和注射针剂相比，它更方便，可以预见，如果滥用这一类的药物会出现很多问题。

“口服剂还没进入医院，但已经有患者来咨询了。”黄青华说，虽然司美格鲁减重效果明显，但它并非一劳永逸，即便是适应症患者，在停药后也会出现体重反弹。

在社交平台上，有不少网友分享自己的经历：根本停不下来，打一年了，一停就反弹；打了8个月，瘦了20斤，管不住嘴又不运动，瘦不下来了；打了10个月，减了35斤，停了快2个月，增加了10多斤……

在黄青华看来，大家对司美格鲁肽的狂热追捧，归根结底还是对减重的焦虑，以及不当认知。

潮新闻·钱江晚报健康小站、杭州拱墅区文晖社区卫生服务中心副主任朱秋静对此深有同感：“很多要打这个针的患者其实不是糖尿病，血糖血脂也没有异常，就是想减重，或者觉得自己不够瘦，想快速变瘦。”

“从减重的角度看，所谓的‘减肥神药’也只是辅助手段，减重首先要找到肥胖的根源，然后对症治疗。” 临床中，黄青华接诊过许多减重不当而自伤的患者，比如过度节食导致月经不调，甚至出现抑郁等精神问题。

据介绍，从国外的临床数据来看，司美格鲁肽确实有减肥的功效，并已在英国、美国、日本等国家作为减肥药上市。但是，这种药的“减肥版”在我国还没有获批。即使“减肥版”在国内获批上市，因为是处方药，所以注射前也应当到专业减重中心或医院做相关检查评估，并在专业医生指导下合理调整剂量，从而以更小的副作用取得更好的获益。

不论是饮食还是运动

减肥都是一个长期坚持的过程

如果非做医美

也一定要去正规医院

选择合理合规的项目

千万不要自己在家盲目DIY！

来源：东方网综合杭州市一医院、潮新闻、锦观新闻

：小冉、小能手

审稿：钱程灿

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rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media screen and (min-width:1024px){body:not(.pages_skin_pc) .wx-root,body:not(.pages_skin_pc) body{--appmsgExtra-BG: #F7F7F7}}@media screen and (min-width:1024px){body:not(.pages_skin_pc) .wx-root[data-weui-theme=dark],body:not(.pages_skin_pc) body[data-weui-theme=dark]{--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: #404040;--weui-BG-5: #2c2c2c;--weui-FG-0: rgba(255, 255, 255, .8);--weui-FG-HALF: rgba(255, 255, 255, .6);--weui-FG-1: rgba(255, 255, 255, .5);--weui-FG-2: rgba(255, 255, 255, .3);--weui-FG-3: rgba(255, 255, 255, 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#3eb575;--weui-BRAND: #07c160;--weui-BLUE: #10aeff;--weui-INDIGO: #1196ff;--weui-PURPLE: #8183ff;--weui-WHITE: rgba(255, 255, 255, .8);--weui-LINK: #7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: #000;--weui-TAG-TEXT-RED: rgba(250, 81, 81, .6);--weui-TAG-BACKGROUND-RED: rgba(250, 81, 81, .1);--weui-TAG-TEXT-ORANGE: rgba(250, 157, 59, .6);--weui-TAG-BACKGROUND-ORANGE: rgba(250, 157, 59, .1);--weui-TAG-TEXT-GREEN: rgba(6, 174, 86, .6);--weui-TAG-BACKGROUND-GREEN: rgba(6, 174, 86, .1);--weui-TAG-TEXT-BLUE: rgba(16, 174, 255, .6);--weui-TAG-BACKGROUND-BLUE: rgba(16, 174, 255, .1);--weui-TAG-TEXT-BLACK: rgba(255, 255, 255, .5);--weui-TAG-BACKGROUND-BLACK: rgba(255, 255, 255, .05)}}@media screen and (min-width:1024px) and (prefers-color-scheme:dark){body:not(.pages_skin_pc) .wx-root:not([data-weui-theme=light]),body:not(.pages_skin_pc) body:not([data-weui-theme=light]){--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: 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div.autoTypeSetting24psection > p,div.autoTypeSetting24psection > section{margin-bottom: 24px;}