局部注射少量A型肉毒毒素治疗上半面部皱纹的临床研究

目的：观察局部注射少量A型肉毒毒素（BTXA）去除上半面部皱纹的临床疗效。方法：应用A型肉毒毒素的198例患者,其中眉间纹65例,鱼尾纹80例,额纹20例,鼻背部皱纹33例。所有患者行局部多点注射A型肉毒毒素,浓度为4U/0.1ml,并根据不同的患者调整剂量和浓度。记录患者疗效、维持时间与不良反应。结果：A型肉毒毒素治疗面部上三分之一皱纹有效率为100%,显效率94.4%。肌肉麻痹的效果通常持续3～6个月不等,不良反应主要为4例上睑下垂,3例局部水肿和4例青紫,各占2.0%、1.5%和2.0%。上述症状于3～10内自行完全消失。结论：A型肉毒毒素局部注射治疗面部上三分之一皱纹起效迅速、无创伤、简便易行。     

应用A型肉毒素治疗眼睑痉挛

目的：讨论应用A型肉毒素治疗眼睑痉挛的疗法。方法：对30例眼睑痉挛患者用BTXA进行局部眼睑下注射前均行眼部常规检查和确定痉挛强度，按治疗标准进行评估。结果：3天后症状完全缓解20例(66．67％)，6例明显缓解(20％)，4例部分缓解(13．33％)，10天后3例患者治疗效果不理想，再次重复注射，完全缓解，效果达100％。所有患者治疗期间未出现并发症。结论：BTXA局部注射是治疗眼睑痉挛的一种安全、有效、简便的方法，可以推广。     

A型肉毒毒素治疗上半面部皱纹1000例

目的：为了治疗上半面部因表情肌活动产生的皱纹,通过注射肉毒毒素到面部相关的肌肉来有效的控制肌肉的活动,从而达到柔和消除面部皱纹的目的。从1996年开始临床应用至今已有1000例病例,其中眉间纹235例,鱼尾纹380例,额纹350例,鼻背部皱纹35例。方法：一般用1．5ml生理盐水稀释55单位BOTOX,并可根据不同的患者调整剂量和浓度。结果：肌肉麻痹的效果通常持续3－6个月不等,除1例出现短暂性的上睑下垂,3例出现局部水肿和青紫外,无局部或全身副作用。结论：肉毒毒素是暂时性消除上半面部动力性皱纹的安全,有效、简便的治疗方法。     

A型肉毒毒素V形对称注射法面部除皱

目的：探讨A型肉毒毒素V形对称注射法在面部除皱中的应用优势。方法：采用A型肉毒毒素V形对称注射治疗面部皱纹，注射点均在靶肌肉内呈V形排布，位置、间距对称，分布均匀，且精确定量。行A型肉毒毒素以V形对称注射法治疗面部皱纹的患者116例，其中额部皱纹患者49例，眉间部皱纹患者23例，鼻背部皱纹患者11例，双侧鱼尾纹患者33例。结果：116例患者中效果优良96例占82.76％，满意18例占l5．52％，失败2例占1．72％。无一例发生中毒、过敏、上睑下垂、复视、下睑外翻等严重并发症。结论：A型肉毒毒素V形对称注射治疗面部皱纹，注射点均在靶肌肉内呈V字形排布，位置、间距对称，分布均匀，且精确定量，能有效的防止并发症的发生，临床效果优良。     

A型肉毒毒素对神经和肌肉影响的效价研究

目的：探讨新鲜和储存的A型肉毒毒素（BTXA）对神经及肌肉的影响，以期指导临床治疗。方法：将27只新西兰白兔随机分成9组，选择耳前肌为注射部位。第1组为对照组，余8组为注射组。各注射组接受BTXA的注射，大体观察各组实验动物右耳下垂的情况；并均于注射后第5天（早期）和第12周（晚期）取注射的肌肉神经行电镜观察。结果：大体观察结果：随储存时间的延长，兔耳下垂的时间越短。肌肉电镜观察结果：在注射后早期（第5天），新鲜及储存的BTXA对肌肉的影响无显著性差异；在注射后晚期（第12周），新鲜及储存1～2周的BTXA比较，两者造成的肌肉萎缩程度无显著性差异，但储存3周的BTXA造成的肌肉变性程度比储存1～2周的BTXA轻。神经电镜观察结果：BTXA注射后神经改变与上述肌肉改变同。结论：储存1～2周的BTXA与新鲜BTXA比较，两者效价基本相同，但储存3周的BTXA效价下降显著。并且，新鲜BTXA及储存1～2周的BTXA对神经肌肉的影响时间较储存3周的BTXA更持久。因此本实验建议临床上储存BTXA的时间不超过2周。     

A型肉毒毒素治疗上半面部皱纹1000例

目的　为了治疗上半面部因表情肌活动产生的皱纹 ,通过注射肉毒毒素到面部相关的肌肉来有效的控制肌肉的活动 ,从而达到柔和和消除面部皱纹的目的。从 1996年开始临床应用至今已有 10 0 0例病例 ,其中眉间纹2 3 5例 ,鱼尾纹 3 80例 ,额纹 3 5 0例 ,鼻背部皱纹 3 5例。方法　一般用 1.5ml生理盐水稀释 5 5单位BOTOX ,并可根据不同的患者调整剂量和浓度。结果　肌肉麻痹的效果通常持续 3～ 6个月不等 ,除 1例出现短暂性的上睑下垂 ,3例出现局部水肿和青紫外 ,无局部或全身副作用。结论　肉毒毒素是暂时性消除上半面部动力性皱纹的安全、有效、简便的治疗方法。     

A型肉毒毒素治疗上半面部皱纹1 000例

目的为了治疗上半面部因表情肌活动产生的皱纹,通过注射肉毒毒素到面部相关的肌肉来有效的控制肌肉的活动,从而达到柔和和消除面部皱纹的目的.从1996年开始临床应用至今已有1?000例病例,其中眉间纹235例,鱼尾纹380例,额纹350例,鼻背部皱纹35例.方法一般用1.5ml生理盐水稀释55单位BOTOX,并可根据不同的患者调整剂量和浓度.结果肌肉麻痹的效果通常持续3～6个月不等,除1例出现短暂性的上睑下垂,3例出现局部水肿和青紫外,无局部或全身副作用.结论肉毒毒素是暂时性消除上半面部动力性皱纹的安全、有效、简便的治疗方法.     

A型肉毒毒素治疗面部肌肉痉挛

目的:通过面部局部注射A型肉毒毒素(botulinumtoxinA,BTXA),探讨治疗面部肌肉痉挛的安全、简单而有效的方法。方法:对82例面部痉挛的患者,根据面部痉挛的部位,确定BTXA的注射点及注射剂量,并可根据产生的作用而行重复注射。结果:注射24h,症状开始改善,2～7天痉挛迅速缓解,所治疗的82例患者症状全部获得了缓解。结论:BTXA已作为一种药物,用于治疗面部的肌肉张力异常和面部神经肌肉兴奋性过高等症。治疗无痛苦、操作简单、恢复快,是治疗面部肌肉痉挛的比较安全有效的技术。     

A型肉毒毒素预防与治疗早期增生性瘢痕的临床初探

目的 探索A型肉毒毒素(botulinum toxin type A,BTXA)对早期增生性瘢痕(hypertrophic scar,HTS)的临床预防及治疗效果.方法 早期HTS周围及组织内注射BTXA,观察瘢痕注射药物后形态学变化、组织学变化及临床症状表现;手术切口缝合后即刻向周围肌肉浅层注射BTXA,观察远期瘢痕愈合情况.结果 局部注射BTXA可以明显减轻早期HTS疼痛和瘙痒症状,促使瘢痕组织萎缩、软化;组织切片HE染色显示HTS组织内结构有所变化.同时,手术切口周围肌肉浅层注射BTXA可以降低术后切口HTS的发生、发展概率.结论 BTXA对早期HTS具有一定程度的治疗和预防作用,其疗效可能是通过降低瘢痕两侧张力及活动,干扰瘢痕内小神经传导,以及影响成纤维细胞增殖分化,促进凋亡进而减少胶原合成而起作用.     

A型肉毒毒素注射治疗面上部动力性皱纹的临床应用

目的：探讨应用A型肉毒毒素注射治疗面上部动力性皱纹的临床效果。方法：回顾按期回访（1周后返院复诊，每月定期电话随访）的126例面上部动力性皱纹患者的临床资料以及肉毒毒素注射的治疗原理，分析126例患者治疗后的临床效果。结果：1周后返院复诊患者126例，93例显效，33例有效，治疗有效率100％，平均维持时间为6～7个月。结论：A型肉毒毒素注射用于治疗面上部动力性皱纹安全有效，但应严格掌握适应证。     

长期重复应用A型肉毒毒素面部除皱的疗效和安全性评价

目的 评价长期重复多次应用A型肉毒毒素（botulinum toxin A,BTXA）进行面部除皱的疗效和安全性.方法 对52例多次使用国产A型肉毒毒素注射面部除皱者进行了回顾性分析总结.每次注射除皱部位均包括额纹、鱼尾纹、眉间纹、鼻背横纹.于注射前和注射后1周、1个月、3个月及再次注射时,分别进行疗效和安全性评价.结果 每例均注射除皱共8次,每次注射后开始起效时间都在3～4 d,1个月左右是最佳表现时间.疗效评价1级为很好的比例依次是额纹100%、鱼尾纹97.1%、眉间纹99.8%、鼻背横纹99.0%,评价2级为好的比例依次是额纹0、鱼尾纹2.9%、眉间纹0.2%、鼻背横纹1.0%,评价为一般、较差、差这3个等级者为0.随着注射次数增多,疗效等级不断提高.平均疗效维持时间有所延长（r=0.256,P=0.02）,为（7.8±1.1）个月,呈正态分布.随着注射次数增加后,不良反应轻微,仅部分受注射者个别注射部位出现瘀斑、额部紧绷感、一定程度的表情僵化和鱼尾纹注射后下眼睑邻近部位皱纹加重.不良反应发生率随注射次数下降（r=0.850,P=0.01）.所有被注射者均未出现严重不良反应.结论 长期多次应用A型肉毒毒素除皱安全可靠,且疗效不受影响,因此可以多次使用.     

Evaluation of Intradermal Injection of Botulinum Toxin A for Facial Lifting

BACKGROUND: Intradermal botolinum toxin A (BTXA) is an advanced technique that emerged in response to the increased demand for noninvasive facial lifting and skin rejuvenation. OBJECTIVE: We sought to evaluate the safety and efficacy of intradermal injections of BTXA for facial lifting. METHODS: Twenty-five female patients with mild symmetrical facial skin laxity were enrolled in this study. All patients were treated with BTXA in one side of the face while the other side was injected with normal saline. The response to treatment was assessed by two dermatologists who evaluated global photographs using a quartile grading scale (QGS). The patient self-assessment and satisfaction questionnaires were recorded. RESULTS: A highly significant difference was found between the side injected with BTXA and the saline injected side (control) (p<0.001). Facial lifting was achieved in 58.66 percent of the sides injected with BTXA. Forty-four percent of patients were very satisfied. Older patients showed better improvement than younger patients (p=<0.001). The results persisted for 16 weeks. No adverse effects were observed. CONCLUSION: Our results suggest that intradermal injection of BTXA could be a safe and effective therapeutic option for face lifting.     

A型肉毒毒素在下面部及颈部的应用

目的 观察A型肉毒毒素在下面部及颈部美容中的应用效果。方法 用生理盐水1．1ml稀释A型肉毒毒素55U，对引起口周、颈部皱纹及露龈笑特定的肌肉进行定点、定量注射。结果 对110例患者进行注射A型肉毒毒素治疗，显效者70例，有效者35例，不对称5例，无效者0例，进行重复注射者92例。结论 注射A型肉毒毒素用于下面部及颈部的美容，操作方法简单、损伤小、安全、有效，并为手术提供了对照研究方法和辅助治疗手段。     

爱贝芙注射除皱的效果评价

目的:探讨爱贝芙对面部不同部位的除皱效果。方法:226例应用爱贝芙进行面部除皱的患者,根据药物注射部位的不同进行分组,比较面部不同部位之间除皱效果的差异,综合分析爱贝芙注射除皱的效果。结果:爱贝芙注射除皱的方法适合额部抬头纹、眉间川字纹、鼻梁横纹、鼻唇沟皱纹等的除皱;对颈部皱纹和眼角鱼尾纹的除皱效果欠理想。结论:应用爱贝芙进行注射除皱适合面部大部分皱纹。     

New indications for botulinum toxin type A in treating facial wrinkles of the mouth and neck

Botulinum toxin type A (BTX-A) is commonly used to smooth hyperkinetic lines in the periocular and forehead areas of the upper face, but has been used less frequently for indications in the lower face and neck. This study was designed to determine whether botulinum toxin treatment of the mouth and neck areas is as clinically successful as treatment of the upper face. This was a retrospective study of patients who were treated with botulinum toxin type A (BOTOX, Allergan, Inc) to soften hyperkinetic facial wrinkles. Of 100 patients randomly selected from a single clinical practice, 91 met the inclusion criteria and were divided into two groups for analysis: the 56 patients in Group 1 did not receive treatment in the mouth and neck areas, while the 35 patients in Group 2 were treated at least once in the mouth and neck areas. Patients were surveyed for periods ranging from seven to 49 months. Most patients in each group had a single BTX-A procedure during this period. Both groups of patients had comparable improvement of wrinkles both at the evaluation immediately after the neuromuscular blockade and during followup. In comparison with patients whose treatment was confined to the upper face, patients who received global treatment with BTX-A, including BTX-A injections in the mouth and neck areas, were injected in more sites per procedure and had more procedures in combination with other therapies. Patient satisfaction with botulinum toxin treatment and outcomes was high in both groups. BTX-A is an important tool within the therapeutic spectrum for the treatment of hyperkinetic facial wrinkles, including those in the areas of the mouth and neck.     

The Safety and Effectiveness of Single-Pass Erbium:YAG Laser in the Treatment of Mild to Moderate Photodamage

BACKGROUND: There are several treatment modalities for mild to moderate photodamage. The demand for effective treatments with minimal side effects has increased. OBJECTIVE: The objective of this study was to determine the effectiveness of short-pulsed erbium:YAG laser in treating mild to moderate photodamage. METHODS: Twenty patients were treated with the short-pulse erbium:YAG laser on the face and neck. One pass was given over the entire face with two to three passes over the perioral and periorbital regions. Patients were evaluated for improvement of pigmentary irregularities, skin texture, and fine wrinkles. All side effects were recorded at follow-up visits. Two lasers were used, Sciton and Cynosure CO3, under local anesthesia. RESULTS: There was a 58% reduction in pigment irregularities and a 54% improvement in skin texture. There was minimal improvement in fine wrinkles with one pass. Two and three passes resulted in a 50% reduction in wrinkles. The procedure was minimally painful. Side effects included 3 to 5 days of erythema and edema. Patients returned to work within 3 days on average. There were no infections. Patient satisfaction with the procedure was rated as very good. There was no difference in efficacy or adverse effects with either laser. CONCLUSIONS: One-pass short-pulse erbium:YAG laser in treating photodamage of the face and neck is safe and effective. There are minimal side effects and patients heal within 3 to 5 days.     

Nlite激光联合微电针除皱在面部年轻化中的应用

目的：探讨将Nlite激光联合微电针除皱应用于面部年轻化美容的临床效果。方法：对皮肤松弛或皱纹明显的面部老化者,联合应用Nlite激光和微电针进行除皱治疗。结果：63例面部皮肤老化者,总有效率为98%,半年有效维持率78%,疗效满意。结论：Nlite激光联合微电针除皱既能改善面部浅表皱纹又能收缩面部肌肉促进其紧缩,具有起效快、效果显著及疗效持久的特点,是面部年轻化美容的好方法。     

Botulinum A Toxin (BOTOX) in the Lower Eyelid: Dose-Finding Study

BACKGROUND: Botulinum toxin type A (BTX-A, BOTOX) is an excellent therapeutic option for hyperkinetic facial lines. It improves wrinkles by relaxing the muscles of facial expression, which underlie the rhytids. Periocular wrinkles such as lateral orbital rhytids respond well to treatment. BOTOX can be used in the lower eyelid to improve wrinkles and widen the eye. OBJECTIVE: To determine whether there is additional benefit in using more than 2 U of BTX-A to improve infraorbital wrinkles and widen the eye. METHODS: Nineteen women had BTX-A injected into the orbicularis oculi muscle. Eleven women had 4 U injected into the lower eyelid bilaterally, 3 mm below the ciliary margin, and 12 U of BTX-A injected into one lateral orbital (crow's feet) area. Eight patients had 8 U injected bilaterally into the lower eyelid and 12 U placed unilaterally into the crow's feet. Physicians and patients independently evaluated the degree of improvement (grade 3=dramatic improvement, grade 2=moderate improvement, grade 1=mild improvement, and grade 0=no improvement). Single investigator analysis was used to measure, in actual millimeters, the amount of increase in palpebral aperture. Side effects were noted. RESULTS: Improvement was noted in lower eyelid wrinkles by both physicians and patients at both dose groups. When only the lower lid was injected, patients reported an improvement of 1.18 with 4 U and a grade of 1.63 with 8 U. When both the lower eyelid the lateral orbital area were treated, an improvement of 1.73 was reported with 4 U and a grade of 2.25 reported with 8 U in the lower eyelid. Physician evaluations had grades of 1.85 for 4 U alone and 1.85 with 8 U alone. Grades of 2.35 and 2.25 were obtained for 4 U plus 12 U and 8 U plus 12 U, respectively. An increase in palpebral aperture (IPA) occurred in all subjects. Subjects who received 4 U in the lower eyelid alone had a 1.8-mm IPA at rest and a 2.6-mm increase at full smile. Subjects who received 8 U of BTX-A alone in the lower lid had an IPA of 2.2 mm at rest and 2.9 mm at full smile. Eyes treated with 12 U in the bilateral orbital area plus 4 U in the lower eyelid had an IPA of 2.2 at rest and 4.5 mm at full smile. Those treated with 8 U in the lower lid plus the crow's feet had an IPA of 1.5 at rest and 4.0 at full smile. Side effects increased with dosage, with eight of eight subjects in the 8-U dose groups reporting bothersome side effects such as lower eyelid edema and incomplete sphincter function. CONCLUSION: A dose-response curve is seen with increasing doses of BTX-A used in the lower eyelid. Treatment of the lateral orbital area in combination with the lower lid produces a synergistic response at lower doses, but at higher doses, a plateau effect is suggested. Although increasing doses of BTX-A increases eye widening, unattractive results and side effects are seen at higher doses. The authors recommend that lower 2- or 4-U doses of BTX-A be used in the lower eyelid and specifically discuss techniques.     

应用A型肉毒毒素去除面上部动力性皱纹82例

目的 应用A型肉毒毒素治疗面上部动力性皱纹，观察其治疗反应及疗效。方法 采用A型肉毒毒素多点注射法治疗面上部动力性皱纹。结果 共治疗82例，包括额纹、鱼尾纹、眉间纹、鼻背纹，有效率达100％。结论 A型肉毒毒素多点注射法安全有效、简便易行，对于面上1／3皱纹具有良好的治疗效果。