非肌电图引导注射A型肉毒毒素治疗麻痹性斜视的观察与护理

The observation and Nursing of subtenon injection of botulinum toxin A for treatment of paralytic strabismus

目的非肌电图引导Tenon氏囊下注射A型肉毒毒素治疗麻痹性斜视的效果探讨及注射前后的护理措施的总结。方法对后天性麻痹性斜视36例患者（36眼）采用直视Tenon氏囊下注射A型肉毒毒素,对患者进行注射前后护理,观察近期及远期疗效并随访3个月。结果该组病例对注射认知全面,依从性良好。注射肌肉包括内直肌30眼,外直肌6眼。注射剂量2.5~5.0 u（平均2.35 u）,注射后5~14d（平均9.36 d）可达最大肌肉麻痹作用,斜视矫正度平均39.20△。近期治愈率44.4%,显效率72.2%。3个月后重复注射者17例,总治愈率58.3%。结论非肌电图仪引导的Tenon氏囊下注射对麻痹性斜视有良好的治疗效果,且全面的注射前后护理是取得良好注射效果的保证。

Objective To explore the clinical efficacy and nursing measurements of subtenon injection of botulinum toxin A without electromyography （EMG） guidance for treatment of paralytic strabismus. Methods Select 36 cases（36 eyes） with acquired paralytic strabismus were treated with subtenon injection of botulinum toxin A. We applied nursing guidance from preinjection to postinjection and the follow-up time was 3months. Results All cases understood the procedure and followed well. 30 eyes＂ rectus medialis and 6 eyes＂ rectus lateralis were treated. The injection dose was 2.5-5.0 u（averge 2.35 u）, The maximum therapeutic paralytic effect occurred in 5-14 days following the injection, The mean correction of strabismus was 39.20 prism diopters. The short-term recovery rate was 44.4%, the clinical effective rate was 72.2%, 17 cases received repeated injections after 3 months, the total recovery rate was 58.3%. Conclusion Comprehensive nursing and observing are obviously helpful for the last success of the injection .The result of subtenon injection of botulinum toxin without electromyography （EMG） guidance is effective to paralytic strabismus.