A型肉毒毒素连续注射和单次注射矫正咬肌肥大的效果比较

目的 研究A型肉毒素注射方式对治疗咬肌肥大效果的影响。 方法 选取2012年12月—2014年12月温州医科大学附属第一医院收治的单纯性咬肌肥大患者36例，其中15例为单次注射组，21例为连续注射组，分别于注射后1、3、6、9、12、18个月测量并比较2组患者的咬肌厚度变化。 结果 2组患者分别经A型肉毒素连续注射与单次注射后，其咬肌厚度变化趋势存在差别，差异具有统计学意义(F=38.91，P＜0.001)；单次注射组治疗前咬肌厚度为(14.80±0.18) mm，治疗后1、3、6、9、12、18个月，咬肌厚度分别为(11.21±0.18) mm、(10.54±0.19) mm、(9.62±0.18) mm、(10.21±0.22) mm、(12.63±0.18) mm、(13.79±0.35) mm，咬肌厚度与治疗前相比，差别均具有统计学意义(F值分别为955.59、1 503.4、2 239.03、1 183.99、384.87、70.39，均P＜0.001)；连续注射组治疗前咬肌厚度为(14.93±0.18) mm，治疗后1、3、6、9、12、18个月后，咬肌厚度分别为(11.41±0.16) mm、(10.62±0.18) mm、(10.00±0.18) mm、(9.50±0.25) mm、(9.33±0.25) mm、(10.44±0.24) mm，咬肌厚度与治疗前相比，差亦均具有统计学意义(F值分别为2 184.58、3 724.88、1 610.48、3 105.48、3 665.60、1 948.86，均P＜0.001)。 结论 连续注射A型肉毒素18个月内治疗单纯性咬肌肥厚效果优于单次注射。 

Clinical differences between sequential injection and single injection of botulinum toxin type A for curing masseteric hypertrophy

Objective To study the clinical effects of different injection methods of Botulinum toxin type A for curing masseteric hypertrophy. Methods A total number of 36 patients with idiopathic masseter hypertrophy in our hospital between December 2012 to December 2014 were enrolled into this study.15 patients received single injection and 21 patients received sequential injection group.By using the repeated measurement design,the masseter thickness of all subjects were detected and compared at the time of 1,3,6,9,12,18 months after the injection. Results The masseter thicknesses of the two groups were different after the injections,and the differences was statistical significant(F=38.91,P<0.001).For the single injection group,the masseter thicknesses was(14.80±0.18)mm before the injection,and decreased to (11.21±0.18)mm,(10.54±0.19)mm,(9.62±0.18)mm,(10.21±0.22)mm,(12.63±0.18)mm and(13.79±0.35)mm at the time of 1,3,6,9,12,18 months after the injection,respectively,the difference was statistical significant(F=955.59,1 503.4,2 239.03,1 183.99,384.87 and 70.39,respectively,P<0.001).For the sequential injection group,the masseter thicknesses was (14.93±0.18)mm before the treatment,and decreased to (11.41±0.16)mm,(10.62±0.18)mm,(10.00±0.18)mm,(9.50±0.25)mm,(9.33±0.25)mm and (10.44±0.24)mm at the time of 1,3,6,9,12,18 months after the injection,respectively,the difference was(F=2 184.58,3 724.88,1 610.48,3 105.48,3 665.60 and 1 948.86,respectively,P<0.001). Conclusion The sequential injection of Botulinum toxin A for 18 months has better clinical effects than the single injection of Botulinum toxin A in the treatment of masseteric hypertrophy.