重复局部注射A型肉毒毒素治疗眼睑及面肌痉挛的疗效观察

目的:观察重复局部注射A型肉毒毒素(BTXA)治疗眼睑及面肌痉挛的长期疗效。方法:对80例眼睑、面肌痉挛的患者(眼睑痉挛75侧,面肌痉挛65侧),连续重复局部注射BTXA 4~20次,共886次,面肌痉挛每次剂量为22.5~32.5 U,眼睑痉挛为12.5~15.0 U。随访2~8年,观察其长期疗效。结果:起效时间多于治疗后2~3 d。眼睑及面肌痉挛治疗后部分缓解、明显缓解、完全缓解分别为0、67.7%、32.7%及1.4%、72.3%、26.3%,总有效率100%。随注射次数增加,药物剂量未增加,药效持续时间分别为(19.9±4.5)周及(20.7±4.2)周(P>0.05)。局部不良反应轻微、短暂。结论:重复局部注射BTXA治疗面肌及眼睑痉挛,在不需增加剂量的情况下,可长期维持其疗效和作用持续时间,而且是一种安全、有效和简便的治疗方法。

The effect of botulinum A toxin repeated injection in treating blepharospasm and hemifacial spasm

OBJECTIVE: To study the long-term efficacy of botulinum A toxin (BTXA) repeated injection for the treatment of blepharospasm and hemifacial spasm (HFS). METHOD: Eighty patients with blepharospasm and/or HFS (75 sides and 65 sides respectively) were treated with constant BTXA local repeated injection over 4 times and the dosage was 12.5-15.0 U and 22.5-32.5 U respectively in each injection. A total number of 886 injections were given. All the patients were followed up for 2-8 years. RESULT: The earliest effect was found in 2-3 days after the treatment. The effective ratios of the partial relieved, remarkably relieved and completely relieved in blepharospasm and HFS were 0, 67.7%, 32.7% and 1.4%, 72.3%, 26.3% respectively. The average duration of improvement lasted about (19.9 +/- 4.5) weeks and (20.7 +/- 4.2) weeks respectively (P>0.05), which increased with the times of injection. The local side effects were mild and transient. CONCLUSION: BTXA for the treatment of blepharospasm and HFS is a safe, effective and simple method.