A型肉毒毒素在美容整形外科的临床应用分析

目的:探讨美容整形外科手术中使用A型肉毒毒素的方法和效果。方法:选择我院2018年1月到2019年1月美容整形外科收治的100例面部除皱患者作为研究对象,并结合其面部皱纹情况对其实施不同注射剂量、不同注射方法的A型肉毒毒素,对患者皱纹改善情况进行比较和分析,并对患者的满意度进行调查。结果:患者在接受治疗之后都产生显著的效果,其中有效人数为94例,总有效率为94%;患者满意人数为98人,总满意率为98%。患者治疗前后差异较为明显(P0.05),具有统计学意义。结论:在患者面部除皱美容中选择A型肉毒毒素治疗能够进一步改善其面部皱纹现象,从而产生显著的效果,对于提升患者临床治疗有效率有着积极的作用,值得在美容整形外科进行使用和推广。     

A型肉毒毒素除皱120例疗效观察

为了探索非手术除皱的新方法 ,自 1999年 5月用国产Ａ型肉毒毒素 (ＢＯＴＯＸ)于面部皱纹处皮下多点注射法 ,治疗 12 0例面部皱纹收到了较好的除皱效果。1　资料和方法1.1　临床资料　男 16例 ,女 10 4例。≤ 40岁 5 0例 ,41～ 5 0岁 40例 ,5 1～ 6 0岁 2 4例 ,≥ 6 0岁 6例。皱纹部位有额纹 ,眼角纹 (鱼尾纹 )、眉间纹、鼻背纹、口周纹。每例接受治疗 2处以上。1.2　方法1.2 .1　除皱剂的配制　采用ＢＯＴＯＸ结晶冻干制剂 ,5 5Ｕ/支 ,每支加入生理盐水 1.3～ 1.5ｍｌ稀释 ,用皮试注射器抽吸药液即可使用。1.2 .2　注射方法　局部先以 75 %…     

BoTox毒素美容受青睐

近年来,随着BoTox(A型肉毒毒素)被FDA(美国食品和药物管理局)正式许可用于美容用途,人们开始用更客观、更科学的态度对待这种毒素,让这种为成千上万人抚平皱纹的药发挥出它应有的作用。 将A型肉毒毒素用于美容医疗用途是加拿大于2001年率先批准的。2002年4月15日,美国食品和药物管理局也通过了BoTox肉毒毒素用于化妆品除皱美容用途的许可,宣布BoTox已被许可用于“暂时性改善中等程度眉间皱纹的治疗”。因为FDA的许可,在美国掀起了一股毒素美容狂潮,即通过注射BoTox,达到快速消除皱纹的目的。在美国,做1次BoTox的注射大概需要花费300美元～1     

眉间纹联合应用A型肉毒毒素和玻尿酸的疗效研究

目的 研究A型肉毒毒素和玻尿酸联合用于眉间纹治疗上的临床疗效。方法 选取2019年1月-2020年3月于海口琼山焦仕程医疗美容诊所接受治疗的90例眉间纹患者作为主要对象,采用数字随机表法将其分为对照组(n=45)和观察组(n=45)。对照组采用A型肉毒毒素治疗,观察组采用A型肉毒毒素+玻尿酸治疗,比较两种治疗方法获得的临床疗效、治疗后的药效持续时间以及并发症发生情况。结果 两组相比较,观察组的治疗总有效率(95.56%)更高,和对照组(82.22%)相比,差异较大,有统计学意义(P<0.05);治疗后对两组患者进行随访,观察组患者治疗后的药效持续时间为(14.51±1.26)个月,对照组患者治疗后的药效持续时间为(8.54±1.38)个月,t=31.784,P<0.05,存在显著差异。局部红肿、畏光流泪、局部淤青以及上睑下垂等并发症发生率较对照组患者,观察组显著较低,差异有统计学意义(P<0.05)。结论 采用A型肉毒毒素联合玻尿酸治疗眉间纹的临床疗效显著,可延长药效的持续时间,且可降低并发症发生率,优势突出,值得进一步推广应用。     

非肌电引导下注射A型肉毒毒素治疗痉挛型脑瘫患儿的护理

目的 探讨非肌电引导下注射A型肉毒毒素治疗痉挛型脑瘫患儿的护理.方法 选择88例四肢痉挛型脑瘫患儿,进行非肌电引导定位后多点注射A型肉毒毒素,从注射前、注射中、注射后等方面加强护理和观察.结果 88例痉挛型脑瘫患儿经A型肉毒毒素注射治疗,均获得良好效果,无一例出现皮下血肿、感染等并发症.结论 对患儿进行规范周到的护理有助于提高肉毒毒素注射疗效,减少并发症发生.     

13例脑血管病合并Meige综合征A型肉毒素治疗及综合干预效果分析

目的探讨脑血管病合并Meige综合征患者A型肉毒毒素治疗及综合干预措施效果。方法本组13例脑血管病合并meige综合征患者在常规脑血管治疗的同时,采取面部肌肉局部多点注射A型肉毒毒素治疗,并采取加强病房环境管理、饮食指导、眼部管理、安全防护、功能训练、心理疏导等综合干预。结果脑血管病合并Meige综合征在常规治疗的同时,采取A型肉毒毒素局部注射治疗和综合干预,效果满意。本组患者均于注射后24小时症状开始改善;3～10天后痉挛明显缓解,药效持续12～24周,平均（14±1.5）周。结论 A型肉毒毒素局部肌肉注射是治疗脑血管病合并Meige综合征的一种安全、有效的方法;综合干预可减轻症状,减少发作频率,提高患者生活质量。     

肉毒毒素为何能消除皱纹

我的朋友想采用注射肉毒毒素的方法消除面部皱纹，请问肉毒毒素是什么？真的能消除皱纹吗？使用后是否安全？     

埋线疗法治疗上面部动力性皱纹

面部动力性皱纹是在皮肤衰老的基础上,由于面部相应部位表情肌反复地习惯性收缩而产生,典型如上面部抬头纹、鱼尾纹、眉间纹等。传统的美容除皱手术治疗创伤较大,且有一定的风险,容易造成面部表情不自然等现象[1]。埋线疗法作为非手术填充疗法中的一种,其应用于美容临床已得到广泛的认可。本文通过介绍埋线疗法治疗上面部动力性皱纹,并探讨埋线疗法治疗该病的可能机制,为广大同道提供参考。     

A型肉毒毒素用于口角歪斜和鼻唇沟不对称的研究

目的在面瘫患者健侧部分面肌中注射A型肉毒毒素用以矫正口角歪斜和不对称的鼻唇沟,以满足美容的需要。方法将2001年1月￣2005年12月来在门诊和住院的部分面瘫患者作为观察对象,除对照组外治疗组分别在健侧面肌中注射A型肉毒毒素,依据注射剂量随机分为5个治疗组:A组(各肌注射1.25U)、B组(各肌注射2.50U)、C组(各肌注射5.00U)、D组(降、提口角肌和颧大、小肌各注射2.50U,笑肌注射5.00U)和E组(降、提口角肌和颧大、小肌各注射5.00U,笑肌注射2.50U),3d后定期观测每例患者双侧口角到门齿中缝的距离差。结果除A组外,各治疗组的口角歪斜和鼻唇沟不对称均得到不同程度的纠正,注射剂量越大起效越快,持续时间越长,但表情动作受到的影响也略大。结论根据口角歪斜和鼻唇沟不对称的程度,在健侧面肌注射相应剂量的A型肉毒毒素,既可以较好地纠正面瘫患者的口角歪斜和鼻唇沟的不对称,又可以避免并发症的发生。     

A-型肉毒毒素皮肤除皱108例效果观察

衰老是一种自然规律,面部皮肤最易衰老和出现皱纹.当化妆已不能掩盖皱纹及衰老的皮肤时,有些人就会求助美容技术来"恢复青春".A-型肉毒毒素(BTX-A)的应用正是一种简便的方法.我院自2001年来,使用A-型肉毒毒素共为108例患者进行了治疗,效果均满意.     

Can Botulinum Toxin Decrease Carer Burden in Long Term Care Residents With Upper Limb Spasticity? A Randomized Controlled Study

ObjectiveTo evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity.MethodThis was a double-blind placebo-controlled trial with a 24-week follow-up period.SettingA 250-bed long term care hospital, the infirmary units of 3 regional hospitals, and 5 care and attention homes.ParticipantsParticipants included 55 long term care patients with significant upper limb spasticity and difficulty in basic upper limb care.InterventionsPatients were randomized into 2 groups that received either intramuscular botulinum toxin A or saline.Main outcome measuresThe primary outcome measure was provided by the carer burden scale. Secondary outcomes included goal attainment scale, measure of spasticity by modified Ashworth score, passive range of movement for shoulder abduction, and elbow extension and finger extension. Pain was assessed using the Pain Assessment in Advanced Dementia Scale.ResultsA total of 55 patients (21 men; mean age = 69, SD =18) were recruited. At week 6 post-injection, 18 (60%) of 30 patients in the treatment group versus 2 (8%) of 25 patients in the control group had a significant 4-point reduction of carer burden scale (P < .001). There was also significant improvement in the goal attainment scale, as well as the modified Ashworth score, resting angle, and passive range of movement of the 3 regions (shoulder, elbow, and fingers) in the treatment group which persisted until week 24. There were also fewer spontaneous bone fractures after botulinum toxin injection, although this did not reach statistical significance. No significant difference in Pain Assessment in Advanced Dementia scale was found between the 2 groups. No serious botulinum toxin type A–related adverse effects were reported.ConclusionLong term care patients who were treated for upper limb spasticity with intramuscular injections of botulinum toxin A had a significant decrease in the caregiver burden. The treatment was also associated with improved scores on patient-centered outcome measures.     

内镜下注射肉毒杆菌毒素治疗贲门失弛缓症8例分析

目的探讨内镜下注射肉毒杆菌毒素治疗贲门失弛缓症的疗效.方法对1999年11月～2001年1月收治的8例贲门失弛缓症患者,内镜下在贲门狭窄部位用A型肉毒杆菌毒素做5点注射治疗,每点用量20U,总量100U,1个月后重复注射1次,同时行食管下段超声内镜检查,观察黏膜层及肌层厚度,周围有无异常低回声区.结果经注射治疗后,有7例临床症状缓解,有效率87.5%,随访5个月～1年余,症状均无复发,1例病人出现一过性胸痛,1例病人出现上腹部隐痛不适.结论内镜下注射肉毒杆菌毒素治疗贲门失弛缓症方法简便,疗效确切,并发症少,不失为治疗该病的一种好方法,尤其对年老伴有其他疾病不能耐受手术、扩张治疗的患者更适宜应用.     

透明质酸钠联合肉毒毒素在改善不同类型上眼睑凹陷中的应用

目的 研究透明质酸钠填充与肉毒毒素联合治疗不同类型上睑凹陷的临床疗效。方法 选取本院2020—2021年眶周老化求美者147例。采用分层随机方法,将单纯上眼睑凹陷者分为A组、B组,将复合型上睑凹陷者分为C组、D组。B组、D组接受单纯透明质酸钠填充,A组、C组采用透明质酸钠与肉毒毒素的联合治疗方案。对比4组上睑凹陷深度及改善值、患者满意度及不良事件发生情况。使用SPSS 21.0进行统计学分析。 剔除随访脱漏者,最终有效统计132例。治疗后3个月,每组上睑凹陷深度测量值与治疗前比较,差异均有统计学意义(P<0.01)。A组(46例)术后3个月上睑凹陷深度测量平均改善值为(0.63±0.41) cm,B组(46例)为(0.49±0.34 )cm,差异无统计学意义(t=1.782,P>0.05)。C组(20例)术后3个月上睑凹陷深度平均改善值为(1.72±0.42)cm,优于D组(20例)的(0.82±0.50)cm(t=6.091,P<0.01)。术后10例求美者出现轻微的淤青、肿胀,5例出现丁达尔现象;患者总体满意率为92.42%。 透明质酸钠填充与肉毒毒素联合治疗不同类型上睑凹陷是一种安全、微创、便捷的治疗方法。与传统单纯的填充治疗相比,联合治疗在改善复合型上眼睑凹陷方面具有更好的疗效,值得临床推广。     

The treatment of hemifacial spasms using botulin

At the Academic Medical Center of the University of Amsterdam the results of treatment of hemifacial spasms (HFS) with botulinum toxin type A were evaluated in a pilot study. Five men and 21 women with HFS were treated with toxin injections. The mean age was 65 years. Most patients were referred from other centers and had been previously treated without success with various medications or with surgical treatment. Treatment took place at the outpatient department. The toxin was injected into the M. orbicularis oculi at the medial and lateral sides of the upper and lower lids. The total dose varied between 6 and 16 LD50. Patients were reinjected on demand. All patients except for one reported satisfying improvement of their spasm. The onset of the beneficial effect was 1-2 days after the injection and the effect lasted about 3 months. All patients were re-examined 1 to 2 weeks after each treatment and showed reduction or disappearance of synkinesias. No systemic side effects occurred and local complications were mild and transient. We conclude that local injection of botulinum toxin appears to be a successful alternative in the current treatment of hemifacial spasm.     

The clinical diagnosis 'wound botulism' in an injecting drug addict

A 38-year-old subcutaneous injecting heroin addict had subacute blurred vision, dysarthria and dysphagia. The next day she could not swallow or speak and developed weakness of all limbs and respiratory failure. Electromyography showed abnormalities compatible with a presynaptic neuromuscular transmission deficit, which supported the diagnosis of botulism. The point of entry was probably a skin abscess due to injections. Treatment with antitoxin and antibiotics resulted in a favourable recovery. Wound botulism is caused by local production of toxin by Clostridium botulinum after wound infection. Although it is a rare variant of botulism, it is increasingly being reported in drug users who inject subcutaneously.     

Treatment of obesity with intragastric injection of botulinum toxin. Is it worth the pinch? An overview of systematic reviews and meta-analysis.

Background and aimsΑvaialble evidence regarding the effectiveness of intragastric injection of botulinum toxin in reducing anthropometric indices of subjects with obesity is conflicting. We evaluated the existing evidence and perform a meta-analysis to assess the efficacy of intragastric botulinum toxin in treating obesity.MethodsWe identified published systematic reviews evaluating the efficacy of intragastric injection of botulinum toxin in patients with overweight or obesity and additionally performed a systematic literature search to retrieve randomized controlled trials on this topic. A random-effects meta-analysis was performed to synthesize the existing studies.ResultsA total of four systematic reviews were included in our overview of systematic reviews and six randomized controlled trials were included in our meta-analysis. Compared to placebo, intragastric injection of botulinum toxin was ineffective in reducing body weight and body mass index after the application of the Knapp-Hartung adjustment (MD = −2.41 kg, 95%CI = −5.21 to 0.38, I² =59% and MD = −1.43 kg/m², 95%CI = −3.04 to 0.18, I² =62%, respectively). Moreover, treatment with intragastric injection with botulinum toxin was not superior to placebo in decreasing waist and hip circumference.ConclusionsBased on the available evidence, intragastric injection with botulinum toxin is an ineffective procedure in reducing body weight and body mass index when the Knapp-Hartung method was applied.     

Hemifacial spasms caused by neurovascular compression

Three patients, one woman aged 52 years and two men aged 63 and 71 years, respectively, had involuntary movement on one side of their face due to hemifacial spasms. The first patient's spasms were misdiagnosed as a tic, the second patient had received injections of botulinum A toxin which gave no improvement and the third patient suffered from persistent symptoms after a first neurovascular decompression without intraoperative EMG monitoring. All three patients underwent microvascular decompression of the facial nerve with intraoperative EMG monitoring. All three patients were cured. Hemifacial spasm is a curable illness if appropriately diagnosed and treated. Oral medications have no effect on the disease. Local injection of botulinum A toxin is indicated when the spasm is mild or when surgery is contraindicated. The primary causative factor is vascular compression of the facial nerve at its exit zone. Therefore, decompressive surgery is the logical treatment, and the best results are obtained with intraoperative EMG monitoring.     

Botulism: cause, effects, diagnosis, clinical and laboratory identification, and treatment modalities

Botulism is a neuroparalytic disease caused by neurotoxins produced by the bacteria Clostridium botulinum. Botulinum neurotoxins (BoNTs) are among the most potent naturally occurring toxins and are a category A biological threat agent. The 7 toxin serotypes of BoNTs (serotypes A-G) have different toxicities, act through 3 different intracellular protein targets, and exhibit different durations of effect. Botulism may follow ingestion of food contaminated with BoNT, from toxin production of C botulinum present in the intestine or wounds, or from inhalation of aerosolized toxin. Intoxication classically presents as an acute, symmetrical, descending flaccid paralysis. Early diagnosis is important because antitoxin therapy is most effective when administered early. Confirmatory testing of botulism with BoNT assays or C botulinum cultures is time-consuming, and may be insensitive in the diagnosis of inhalational botulism and in as many as 32% of food-borne botulism cases. Therefore, the decision to initiate botulinum antitoxin therapy is primarily based on symptoms and physical examination findings that are consistent with botulism, with support of epidemiological history and electrophysiological testing. Modern clinical practice and antitoxin treatment has reduced botulism mortality rates from approximately 60% to < or =10%. The pentavalent botulinum toxoid is an investigational product and has been used for more than 45 years in at-risk laboratory workers to protect against toxin serotypes A to E. Due to declining immunogenicity and potency of the pentavalent botulinum toxoid, novel vaccine candidates are being developed.     

Botulinum toxin treatment of spasmodic torticollis.

We reviewed the efficacy and adverse effects of repeated botulinum toxin injections into hyperactive neck muscles of 107 successive patients with spasmodic torticollis. They received 510 injection treatments over a median period of 15 months (range 3-42 months). One patient failed to benefit at all, but 101 (95%) patients reported considerable (moderate or excellent) benefit from at least one treatment. On a global subjective response rating, 93% of 429 treatments resulted in some improvement and 76% in moderate or excellent improvement. Pain reduction followed 89% of 190 treatments with moderate or excellent reduction after 66%. Median duration of benefit was 9 weeks. All torticollis types responded equally well and injections into two (or more) involved neck muscles were more effective than injection into a single muscle. The most frequent adverse effect was dysphagia, occurring after 44% of all treatments, but this was severe after only 2%. Antibodies to botulinum toxin were detected in the serum of three out of the five patients in whom loss of treatment efficacy occurred. We conclude that botulinum toxin treatment is the most effective available therapy for spasmodic torticollis and practical advice is provided for anyone wishing to set up the technique.