A型肉毒杆菌毒素局部注射在斜视治疗中的应用  

Application of local injection of botulinum toxin A in the treatment of strabismus

作　　者：吕瑞娟 刘陇黔[1] Lyu Ruijuan;Liu Longqian(Department of Ophthalmology,West China Hospital,Sichuan University,Laboratory of Optometry and Vision Sciences,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院眼科,四川大学华西医院眼视光学与视觉科学研究室,成都610041

出　　处：《中华实验眼科杂志》2025年第2期158-163,共6页Chinese Journal Of Experimental Ophthalmology

摘　　要：A型肉毒杆菌毒素(BTA)是肉毒杆菌产生的一种嗜神经外毒素,能通过化学性去神经作用使肌肉麻痹,在眼科、皮肤科及医疗整形方面应用广泛。在眼科领域,BTA早期被用于治疗婴儿型内斜视、急性共同性内斜视、神经麻痹性斜视等少数类型的斜视。近年来,有眼科医师尝试将BTA应用于部分调节性内斜视、限制性斜视及外斜视,并发现BTA在急性共同性内斜视、部分调节性内斜视、≤30棱镜度的婴儿型内斜视的治疗中可替代眼外肌手术,在超大度数婴儿型内斜视、知觉性外斜视的治疗中可辅助增强手术矫正效果,这为不同类型斜视的治疗提供了新思路。同时,通过改进注射技术、使用剂量增量方法控制药量,增加了局部药物利用率,减少了并发症。本文就BTA治疗斜视的机制、有效性、安全性及应用剂量进行探讨,重点对其在各种类型斜视治疗的效果进行分析比较,以期为BTA在斜视领域的应用提供参考。Botulinum toxin A(BTA),a kind of botulinum exotoxin,which may cause muscular paralysis by the impact of chemical denervation,is commonly utilized in ophthalmology,dermatology,and medical plastic surgery.In the field of ophthalmology,it was first employed to address infantile esotropia,acute concomitant esotropia,nerve paralytic strabismus,and other kinds of strabismus.In recent years,some ophthalmologists have attempted to use BTA to correct partial accommodative esotropia,restrictive strabismus and exotropia,and found that BTA may be used as an alternate approach for extraocular muscles surgery in specific forms of strabismus,such as acute concomitant esotropia,partial accommodative esotropia and infantile esotropia(≤30 prism diopter),and can enhance the effect of surgical correction in the correction of large-angle infantile esotropia and sensory exotropia.This provides a new notion for the treatment of different types of strabismus.At the same time,by improving the injection technique and using the dose increment to control the drug dosage,the local drug utilization rate has been increased,and the complications has been reduced.The mechanism,efficacy,safety,and dosage of BTA in the correction of strabismus are discussed in this article,and the efficacy of BTA in correction of various types of strabismus is analyzed and compared to provide references for the use of BTA in strabismus.

关 键 词：A型肉毒杆菌毒素 斜视 治疗 

分 类 号：R777.41[医药卫生—眼科]