A型肉毒杆菌毒素在腹腔开放后腹壁缺损修复中的应用  

Research on the application of botulinum toxin type A in the repair of abdominal wall defects after abdominal opening

作　　者：王苏睿 胡根 邵国益 Wang Surui;Hu Gen;Shao Guoyi(Affiliated Jiangyin Clinical College of Xuzhou Medical University,Jiangyin City,214400,Jiangsu Province,China;Department of General Surgery,The Affiliated Jiangyin Hospital of Nantong University,Jiangyin 214400,China)

机构地区：[1]徐州医科大学江阴临床学院,江苏无锡214400 [2]南通大学附属江阴医院,江阴市人民医院普外科,江苏无锡214400

出　　处：《中华疝和腹壁外科杂志(电子版)》2024年第6期649-653,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：无锡市卫生健康委中青年拔尖人才项目(HB2023102);江阴市中青年卫生优秀人才项目(JYROYT202301);徐州医科大学附属医院发展基金重点项目(XYFZ202302)。

摘　　要：目的探究A型肉毒杆菌毒素(BTA)在腹腔开放后腹壁缺损修复中应用的有效性与安全性。方法回顾性分析2018年7月至2024年3月江阴市人民医院普外科收治的15例腹腔开放后腹壁缺损患者的临床资料,所有患者均予以注射BTA,并在注射2周后腹部CT和超声检查评估腹壁肌肉厚度、长度、密度、腹壁缺损直径及疝囊腹腔容积比等的变化,统计分析治疗前后各项指标变化情况。结果与注射前比较,15例患者注射后2周左侧腹壁肌肉厚度减少(9.93±6.40)mm,右侧腹壁肌肉厚度减少(9.62±4.73)mm,左侧腹壁肌肉长度增加(24.48±21.66)mm,右侧腹壁肌肉长度增加(18.64±21.60)mm,腹壁缺损直径减少(11.91±10.09)mm,侧腹壁肌肉密度减少(10.67±7.96)HU,疝囊腹腔容积比减少3.61%(6.52%),腹腔内横径增加(9.59±11.60)mm,差异均有统计学意义(P<0.05)。BTA腹壁注射后对患者排便、排尿功能均无显著影响。结论BTA用于腹腔开放后腹壁缺损修复有效且安全。Objective To investigate the efficacy and safety of botulinum toxin type A(BTA)in the repair of abdominal wall defects after abdominal opening.Methods A retrospective analysis was conducted on the clinical data of 15 patients with abdominal wall defects after open abdominal cavity treated at the Department of General Surgery,Jiangyin People&apos;s Hospital,from July 2018 to March 2024.All patients were injected with BTA,and changes in abdominal wall muscle thickness,length,density,defect diameter,and the hernia sac-to-abdominal cavity volume ratio were evaluated 2 weeks after injection.The changes in these parameters before and after treatment were statistically analyzed.Results Compared with before injection values,2 weeks after botulinum toxin injection,the left abdominal wall muscle thickness of 15 patients decreased by(9.93±6.40)mm,and the right abdominal wall muscle thickness decreased by(9.62±4.73)mm.The left abdominal wall muscle length increased by(24.48±21.66)mm,and the right abdominal wall muscle length increased by(18.64±21.60)mm.The abdominal wall defect diameter decreased by(11.91±10.09)mm,the lateral abdominal wall muscle density decreased by(10.67±7.96)HU,and the hernia sac-to-abdominal cavity volume ratio decreased by 3.61%(6.52%).The transverse diameter of the abdominal cavity increased by(9.59±11.60)mm.All differences were statistically significant(P<0.05).Abdominal injection of BTA did not have a significant effect on the patients&apos;bowel or urinary functions.Conclusion BTA is effective and safe for the repair of abdominal wall defects after abdominal opening.

关 键 词：腹腔开放 腹壁缺损 肉毒杆菌毒素 机械组织结构分离 化学组织结构分离 

分 类 号：R65[医药卫生—外科学]