A型肉毒毒素治疗偏侧面肌痉挛患者的疗效及瞬目反射的变化  

Effects of botulinum toxin A on hemifacial spasm and changes of blink reflex

作　　者：傅敏 陈名峰[1] Fu Min;Chen Mingfeng(Department of Internal Medicine,Fujian Provincial Hospital,Fuzhou City,350001,China)

机构地区：[1]福建省立医院南院内科,福州市350001

出　　处：《现代电生理学杂志》2021年第2期72-75,共4页Journal of Modern Electrophysiology

摘　　要：目的:探讨A型肉毒毒素治疗偏侧面肌痉挛患者的疗效及瞬目反射的变化。方法:选取2018年2月至2020年1月就诊于福建省立医院南院的偏侧面肌痉挛患者23例,患者均采用A型肉毒毒素治疗,观察治疗效果及面肌痉挛程度的变化,并比较治疗前后瞬目反射波幅。结果:治疗后,痊愈患者15例(65.2%),痉挛轻度残留8例(34.8%),其中一次治疗21例,重复治疗2例。2例患者用药后流涎,3例患者用药后口角下垂,症状短暂且轻微,两周内均自然消失。随访3个月,复发患者2例,复发率为8.7%。根据Cohen分级标准,治疗前无0~Ⅰ级病例,Ⅲ级病例占比最高(52.2%,12/23例),治疗后,无Ⅲ级、Ⅳ级病例,0级病例占比最高(65.2%,15/23例),差异具有统计学意义(P<0.05)。治疗前后,患侧R1、R2、R2'波幅较健侧波幅明显升高,差异具有统计学意义(P<0.05),治疗后与治疗前比较,患侧R1、R2、R2'波幅明显降低(P<0.05)。结论:A型肉毒毒素治疗偏侧面肌痉挛,对患者神经电生理可产生正向刺激,缓解或消除痉挛症状,改善神经功能状态。Objective:To analyze the effects of botulinum toxin A on hemifacial spasm and changes of blink reflex.Methods:Twenty-three patients with hemifacial spasm from February 2018 to January 2020 in Fujian Provincial Hospital were enrolled in the study.All patients were treated with botulinum toxin A.The therapeutic effect and the degree of hemifacial spasm were observed,and the blink reflex amplitude before and after the treatment was compared.Results:After the treatment,15 cases(65.2%)were cured,8 cases(34.8%)had mild residual spasm,21 cases were treated once and 2 cases were treated repeatedly.Two patients salivated after the treatment,and three patients had ptosis of labial angle,but the symptoms were mild and lasted for a short time,and disappeared naturally within two weeks.After 3 months follow-up,2 cases recurred,and the recurrence rate was 8.7%.According to Cohen grading standard,there were no grade 0-Ⅰ cases,and grade Ⅲ cases accounted for the highest proportion(52.2%,12/23 cases)before the treatment.After the treatment,there were no grade Ⅲ and Ⅳ cases,and grade 0 cases accounted for the highest proportion(65.2%,15/23 cases),the difference was statistically significant(P<0.05).Before and after the treatment,the amplitude of R1,R2 and R2'on the affected side was significantly higher than that on the healthy side(P<0.05).After the treatment,the amplitude of R1,R2 and R2'on the affected side was significantly lower than that before the treatment(P<0.05).Conclusion:Botulinum toxin A in the treatment of hemifacial spasm can produce positive stimulation on neuroelectrophysiology of patients,relieve or eliminate spasm symptoms,improve neurological state,and the application effect is good.

关 键 词：偏侧面肌痉挛 肉毒毒素类 电生理学 瞬目反射 

分 类 号：R745.12[医药卫生—神经病学与精神病学]