A型肉毒杆菌毒素治疗眼睑痉挛21例临床疗效观察

Clinical curative effect of botulinum toxin A (BTXA) on treating spasm of eyelid

目的 探讨A型肉毒杆菌毒素治疗眼睑痉挛的临床疗效。方法 对 2 1例眼睑痉挛的患者进行眼睑皮下眼轮匝肌内 7点注射A型肉毒杆菌毒素 ,每个点注射 2 .5U ,伴有面肌痉挛 9例追加颧面部肌肉 2 - 3处注射。结果 2 1例患者均于注射后 1- 6天痉挛逐渐缓解 ,大部分患者在 3天内缓解。按照Jankovic分级及疗效评价标准 ,显著改善者 12例 (5 7.14 % ) ,改善者 9例 (4 2 .86 % )。经随访 ,19例患者疗效维持时间 2 - 19周 ,平均 (16± 3.7)周 ,有 2例患者注射次数≥ 9次 ,1例注射 36次的患者从第 5次注射后疗效维持时间逐渐缩短 ,末次为 2周。注射后副作用 :暂时眼睑闭合不全 6例 (2 8.5 7% ) ,轻度上睑下垂 2例 (9.5 2 % ) ,眼睑轻度肿胀 3例 (14 .2 9% ) ,流泪 2例(9.5 2 % )。结论 本疗法疗效可靠 ,简便易行 ,药效持续时间较长 ,并发症轻而且可逆转 ,无全身毒副作用 。

Objective To discuss the clinical cruative effect of botulinum toxin A (BTXA) for treating eyelid's spasm.Methods 21 cases with spasm of eyelid were injected in 7 points of orbiaularis oculi with botulnum A toxin injection. The dose was 2.5u. 9 cases with spasm of eyelid and facial muscle were injected additionally in 2-3 points of facial muscle.Results 21 cases after being injected with BTXA for 1~6 days , the spasm relieved gradually. Most cases relieved in 3 days. According to Jankovic's evaluation scale. 12 cases were improving significantly (57.14%). 9 cases were improving (42.86%). The drug effect time was 2-19 weeks in follow-up survey after botulinum A toxin injection, mean 16±3.7 weeks. The injected times of 2 cases were 9 or more. The drug effect time of 1 cases shortened to 2 weeks after the 5th injection. After injection, there were 6 cases with temporary fissura palpebrae (28.57%), 2 cases with slight ptosis (9.52%), 3 cases with slight eyelid swelling (14.29%), 2 cases with shedding tears (9.52%).Conclusion The curative effect of BTXA on treating spasm of eyelin and facial muscle is reliable and effective. The complications are rare and reversible. There are not significant Side-effect. It is a primary method of treating spasm of eyelid.