超声定位肌电图引导下A型肉毒毒素治疗重度流涎的临床观察

A Study of Botulinum Toxin Type A Treatment by Ultrasound-located,Electromyogram-guided of Severe Sialorrhoea

目的:评价A型肉毒毒素(BTX-A)治疗流涎的疗效。方法:选择流涎患者5例,其中帕金森病(PD)3例,脑梗死2例。采用教师流涎分级法(TDS)及流涎频率评分后于超声定位后肌电图引导下对患者腮腺和颌下腺进行BTX-A多点注射,于治疗前及治疗后2周、1个月和3个月时进行流涎测评。结果:TDS和流涎频率评分:BTX-A治疗前为(4.6±0.5)分和(3.0±0.0)分;BTX-A注射后2周降至(2.6±0.9)分和(1.6±0.5)分;1个月时为(2.8±1.1)分和(1.8±0.8)分,与治疗前比,差异有统计学意义(P<0.05);3个月时为(3.2±1.3)分和(2.0±1.0)分,与治疗前比,差异仍有统计学意义(P<0.05)。5例患者均无明显并发症出现。结论:BTX-A局部注射治疗流涎是一种安全、有效的新方法。

Aim：To evaluate the effects of injections of botulinum toxin type A（BTX-A） on patients with sialorrhoea.Methods：Five patients were treated with BTX-A injections in the parotid gland and submandibular gland,which were done by ultrasound-located and electromyogram-guided.Three patients diagnosis were Parkinson＇s disease,and two patients diagnosis were cerebral infarction.Teacher drooling sizing（TDS） and saliva flow rate were utilized to measure the degree of the sialorrhoea.TDS and saliva flow rate were measured before the treatment,2 weeks,1 month and 3 months after the treatment.Results：The TDS and saliva flow rate were（4.6±0.5） and（3.0±0.0） before the BTX-A treatment.The scores were（2.6±0.9） and（1.6±0.5） at 2 weeks,（2.8±1.1） and（1.8±0.8） at 1 month after the treatment.After 3 months TDS and saliva flow rate were（3.2±1.3） and（2.0±1.0）,there was significant statistical difference（P0.05） between the TDS and saliva flow rate before the treatment.No severe side effects were observed in the five patients.Conclusion：The study suggested that BTX-A may be an effective and novel means in the management of patients with sialorrhoea.