104例痉挛性斜颈临床特点及A型肉毒毒素疗效分析

Clinical Characteristics of 104 Patients with Spastic Torticollis and the Effect of Botulinum Toxin A

目的:分析104例痉挛性斜颈的临床特点、A型肉毒毒素的临床疗效及其与临床特点相关性。方法:回顾分析我院2012年1月至2019年12月住院的符合痉挛性斜颈诊断标准的患者104例,统计患者临床特点;分析A型肉毒毒素疗效在不同性别、年龄、体质指数、教育年限、病程、临床分型、注射次数、注射总量、平均每次注射剂量、注射方式各方面的差异性及治疗后不良反应的发生情况。结果:痉挛性斜颈患者男:女=1:1.36,年龄以40~50岁为主,且以40~50岁发病较多,病程(56.84±82.19)个月,发病到确诊间隔时间(22.75±57.44)个月,疾病早期易误诊为颈椎病;易合并精神情绪类疾病;其病因与劳累、情绪异常、饮酒和相关部位的外伤等有关,69.23%的患者在日常生活中起病,64.42%患者情绪激动、劳累或者行走时症状明显;A型肉毒毒素治疗有效率97.22%,A型肉毒毒素疗效与年龄、性别、体质指数、教育年限、病程、临床分型、注射次数、注射总量、平均每次注射剂量之间均无统计学差异(P>0.05);不良反应发生率10.58%。结论:痉挛性斜颈女性多于男性,年龄多在40~50岁;痉挛性斜颈的临床诊断较困难,病程长,发病多与劳累、情绪等因素有关,早期应防止误诊。A型肉毒毒素治疗痉挛性斜颈有效率较高且不良反应较少,多次注射未见疗效明显降低,但是否有其他影响因素不能肯定。

Objective:To analyze the clinical characteristics of 104 cases of spastic torticollis,the clinical efficacy of botulinum toxin type A,and its correlation with clinical characteristics.Methods:A retrospective analysis of 104 patients who met the diagnostic criteria for spastic torticollis in our hospital from January 2012 to December 2019 was analyzed,and the clinical characteristics of the patients were statistically analyzed.The efficacy of botulinum toxin type A was analyzed in terms of gender,age,body mass index,and Education years,duration of illness,clinical classification,number of injections,total number of injections,average dose per injection,differences in injection methods,and occurrence of adverse reactions after treatment.Results:Patients with spastic torticollis male:female=1:1.36,the age is mainly 40-50 years old,and 40-50 years old are more onset,the course of disease is (56.84±82.19) months,the interval between onset and diagnosis is (22.75)±57.44 months,the early stage of the disease is easy to be misdiagnosed as cervical spondylosis;it is easy to merge with mental and emotional diseases;its etiology is related to fatigue,mood disorders,drinking,and trauma to related parts.69.23% of the patients start the disease in daily life,64.42 % Patients are emotionally excited,tired or have obvious symptoms when walking;the effective rate of type A botulinum toxin treatment is 97.22%,and the effect of type A botulinum toxin is related to age,gender,body mass index,education years,duration of disease,clinical classification,number of injections,and injections There was no statistical difference between the total amount and the average dose per injection (P>0.05);the incidence of adverse reactions was 10.58%.Conclusion:There are more women with spastic torticollis than men,and they are mostly between 40 and 50 years old.The clinical diagnosis of spastic torticollis is difficult,the course of the disease is long,and the incidence is mostly related to factors such as fatigue and emotion.Early misdiagnosis should be prevented.Botulinum toxin type A is more effective in the treatment of spastic torticollis and has fewer adverse reactions.Multiple injections have not seen a significant decrease in efficacy,but it is uncertain whether there are other influencing factors.