A型肉毒毒素在治疗腓肠肌肥大中的作用

Effect of domestic botulinum toxin type A on gastrocnemius hypertrophy

目的采用B超联合小腿周径测量客观评价A型肉毒毒素在治疗腓肠肌肥大中的作用。方法自2020年8月至2021年10月,中国医学科学院北京协和医学院整形外科医院对21例腓肠肌肥大要求瘦小腿的求美者采用A型肉毒毒素注射治疗,每侧腓肠肌各注射100 U/例;在注射前和注射后4、12、24周时,测量双侧小腿最粗处的周径,并采用B超于术前及术后4、12、24周测量腓肠肌收缩状态下内侧头和外侧头厚度,评价治疗效果。结果21例患者术后获随访6个月,12周后腓肠肌内、外侧头的厚度分别为(14.06±2.41)mm和(12.46±1.43)mm,内、外侧头减少的厚度分别为原厚度的(19.44±11.46)%和(25.71±8.57)%;24周后腓肠肌的肌肉厚度较12周时出现轻微回升,内、外侧头的厚度分别为(16.46±1.78)mm和(15.86±1.14)mm。4周时小腿最粗处周径减少了(0.98±0.8)%,12周时周径减少了(3.86±1.55)%,24周时为(1.63±0.94)%。结论A型肉毒毒素能通过有效减少腓肠肌的厚度来达到瘦小腿的作用;通过B超测量收缩状态下腓肠肌肌肉厚度结合小腿周径测量能有效地反映腓肠肌萎缩达到的瘦腿效果。

Objective To evaluate the effect of Chinese botulinum toxin type A on gastrocnemius hypertrophy by B-mode ultrasound combined with calf circumference measurement.Methods From August 2020 to October 2021,twenty-one female who were diagnosed as gastrocnemius hypertrophy were enrolled in this study.All the patients were treated with botulinum toxin type A at Plastic Surgery Hospital of Peking Union Medical College,CAMS.Twenty-one female were enrolled in this study.Each side of gastrocnemius muscle was injected with 100 U each case.Calf circumference of the thickest part of both legs was measured before and at 4,12,and 24 weeks after injection and the thickness of the medial and lateral head of bilateral gastrocnemius muscles at contracted status was measured preoperatively,12 weeks and 24 weeks postoperatively using B-ultrasound.Results The 21 patients were followed up for 6 months.The thickness of gastrocnemius muscles is(14.06±2.41)mm(the medial head)and(12.46±1.43)mm(the lateral head)at 12 weeks and the mean reduction of gastrocnemius muscles thickness were(19.44±11.46)%in the medial head and(25.71±8.57)%in the lateral head.At 24 weeks,the thickness of the muscle has a slight growth compared to 12 weeks,which is(16.46±1.78)mm(the medial head)and(15.86±1.14)mm(the lateral head).The reduction in calf circumfer ence was(0.98±0.8)%at 4 weeks,(3.86±1.55)%at 12 weeks,and(1.63±0.94)%at 24 weeks.Conclusion Botulinum toxin type A is effective in treating hypertrophy of the gastrocnemius muscle.B-ultrasound combined with calf circumference measurement could effectively reflect the reduction of muscle thickness after domestic botulinum toxin type A injection.