医源性肉毒毒素中毒(附3例报告及文献复习)

目的报告医源性肉毒毒素中毒相关的严重不良事件。方法总结分析3例医源性肉毒毒素中毒患者的临床表现特征、治疗和预后等临床资料,并结合文献复习进行讨论。结果 3例女性患者均为美容而局部注射肉毒毒素,于注射后数天内出现吞咽困难、呼吸费力、双眼睑显著下垂、视物模糊、头晕、全身无力等症状。患者入院后经支持治疗后症状缓解,3个月后随访恢复良好。结论应用肉毒毒素治疗或美容可引发严重不良事件。临床医生应熟知治疗肌肉的解剖学和肉毒毒素的药理学特征以避免发生严重不良事件。

Latrogenic Botulism (Reports of three Cases and Literature Review)

Aim To report the serious adverse events associated with iatrogenic botulism.Methods The clinical characteristics of 3 iatrogenic botulism patients were described.Combined with the published documents,clinical manifestations of botulism and therapy were discussed.Results Three patients were admitted to hospital because of dysphagia,respiratory compromise,marked bilateral ptosis,blurred vision,dizziness,and generalized muscle weakness,which were happened several days after local injection of botulinum toxin for cosmetic purpose.After the supporting therapy,the symptoms of all patients relieved and recovered well.Conclusion Botulinum toxin may cause serious adverse events after its therapeutic and cosmetic use.Clinicians should be familiar to the anatomy of the treated muscles and the pharmacology of botulinum toxin in order to avoid serious adverse events.