A型肉毒毒素治疗痉挛性斜颈的长期有效性及相关因素的临床分析

发布时间：2018-06-14 10:26

  本文选题：A型肉毒毒素 + 痉挛性斜颈　； 参考：《苏州大学》2014年硕士论文

【摘要】：目的：探讨发病年龄、性别、病程等因素对A型肉毒毒素治疗痉挛性斜颈的长期有效性的影响。 方法：选择2009年1月至2012年8月期间,在苏州大学附属第二医院诊断为痉挛性斜颈的患者54例，在肌电图引导下行胸锁乳突肌、头夹肌、颈夹肌、斜方肌、肩胛提肌、斜角肌等颈部肌肉多点局部注射治疗，在治疗前、治疗后半月、1月、3月、6月、18月、42月进行电话或门诊复诊随访，并以末次注射后18个月的疗效来分析发病年龄、病程（发病至首次A型肉毒素治疗时间）、性别、临床分型、病情严重程度等因素对A型肉毒毒素治疗的长期效果的影响，同时进行安全性观察。 结果：47例患者完成了最终随访，其中31例患者经过1次A型肉毒毒素注射治疗，21例(68%)有效，16例经过2次及2次以上的A型肉毒毒素注射治疗，13例(81%)有效；年龄＜45岁31例，26例有效(84%)有效，≥45岁16例，，8例(50%)有效，年龄＜45岁组疗效显著优于年龄≥45岁组（P=0.020）；病程＜3年33例，27例(82%)有效，≥3年14例，7例(50%)有效，病程＜3年组疗效显著优于病程≥3年组（P=0.026）；性别、临床分型、病情严重程度对A型肉毒毒素的疗效无显著性的影响（P=0.664，P=0.596，P=0.693）。 47例患者中15例出现颈部无力，4例出现吞咽困难，1例出现流感样症状，2例出现颈痛，均自然缓解。 结论：A型肉毒毒素长期治疗痉挛性斜颈是有效和安全的，发病年龄、病程对A型肉毒毒素治疗痉挛性斜颈的疗效有显著的影响。
[Abstract]:Objective: to investigate the effects of age, sex and course of disease on the long-term efficacy of botulinum toxin type A in the treatment of spastic torticollis. Methods: from January 2009 to August 2012, 54 cases of spasmodic torticollis were diagnosed in the second affiliated Hospital of Suzhou University. The sternocleidomastoid muscle, cephalocephalic muscle, cervical clip muscle, trapezius muscle, levator scapularis muscle were guided by electromyography (EMG). Scalene muscle and other cervical muscles were treated by multi-point local injection. The patients were followed up by telephone or outpatient for half a month, one month, three months, six months, eighteen months and forty-two months after treatment, and the age of onset was analyzed by 18 months after the last injection. Effects of course of disease (from onset to first botulinum toxin A treatment time, sex, clinical type, severity of illness, etc.) on the long-term efficacy of botulinum toxin A treatment were observed at the same time. Results the final follow-up was completed in 47 cases. Among them, 31 cases were treated with botulinum toxin A injection (21 cases). 16 cases were treated with botulinum toxin A injection for 2 times and more than 2 times. 13 cases were treated with botulinum toxin A injection (n = 13). Age < 45 years 31 cases (26 cases) effective), age 鈮

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