[1]汪晓瑜,王小莉,喻 磊,等.非肌电图引导Tenon氏囊下注射不同剂量A型肉毒毒素治疗先天性内斜视临床疗效观察[J].陕西医学杂志,2022,51(2):219-221,244.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.021]
　WANG Xiaoyu,WANG Xiaoli,YU Lei,et al.Curative effect of different doses of botulinum toxin A injected under Tenon's capsule under guidance of non-electromyography in treatment of congenital esotropia[J].,2022,51(2):219-221,244.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.021]
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非肌电图引导Tenon氏囊下注射不同剂量A型肉毒毒素治疗先天性内斜视临床疗效观察
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年2期
页码:
219-221,244
栏目:
药物与临床
出版日期:
2022-02-05

文章信息/Info

Title:
Curative effect of different doses of botulinum toxin A injected under Tenon's capsule under guidance of non-electromyography in treatment of congenital esotropia
作者:
汪晓瑜; 王小莉; 喻 磊; 田冰玉; 王 萍
(西安市人民医院 西安市第四医院,陕西 西安710004)
Author(s):
WANG Xiaoyu; WANG Xiaoli; YU Lei; TIAN Bingyu; WANG Ping
(Xi'an People's Hospital,Xi'an 710004,China)
关键词:
A型肉毒毒素;  先天性内斜视;  非肌电图;  Tenon氏囊;  不同剂量;  临床疗效
Keywords:
Botulinum toxin A;  Congenital esotropia;  Non-electromyography;  Tenon's capsule;  Different doses;  Clinical effect
分类号:
R 777.4
DOI:
DOI:10.3969/j.issn.1000-7377.2022.02.021
文献标志码:
A
摘要:
目的:探讨非肌电图引导下Tenon氏囊下注射不同剂量A型肉毒毒素(BTX-A)治疗先天性内斜视的临床疗效。方法: 收集37例麻痹性斜视患儿的临床资料,患儿均予以非肌电图引导下Tenon氏囊下注射BTX-A,根据BTX-A使用剂量分为A组(1.25～2.5 U)、B组(2.5～3.75 U),比较两组治疗疗效,并随访6个月,检查其双眼视功能,统计不良反应及再注射率。结果: A组一次性治愈率61.11%,显著低于B组85.29%(P<0.05); 治疗后两组双眼视功能分级及左右眼等效球镜比较无统计学差异(均P>0.05),但B组看远斜视度(3.61°±1.43°)显著低于A组[(6.34°±1.75°),P<0.05]; A组不良反应发生率20.00%,与B组10.00%比较无统计学差异(P>0.05),但A组再注射率41.67%,显著高于B组17.65%(P<0.05)。结论:非肌电图引导下Tenon氏囊下注射BTX-A可有效改善先天性内斜视患儿斜视症状,且剂量≥2.5 U时的治疗疗效更佳。
Abstract:
Objective:To investigate the clinical curative effect of different doses of botulinum toxin A(BTX-A)injected under Tenon's capsule under the guidance of non-electromyography(EMG)in the treatment of congenital esotropia.Methods:The clinical data of 37 children with paralytic esotropia were collected.All children were injected with BTX-A under Tenon's capsule without EMG guidance.According to the dosage of BTX-A,they were divided into group A(1.25 to 2.5 U)and group B(2.5 to 3.75 U).The therapeutic effects of the two groups were compared.They were followed up for 6 months to check their binocular visual function,and the adverse reactions and reinjection rate were counted.Results:The one-time cure rate of group A was significantly lower than that of group B(61.11% vs.85.29%,P<0.05).There was no statistically significant difference in the grade of binocular visual function and binocular spherical equivalent between the two groups after treatment(all P>0.05),but the looking far esotropia degree of group B was significantly lower than that of group A [(3.61°±1.43°)vs.(6.34°±1.75°),P<0.05].There was no statistically significant difference in the incidence of adverse reactions between group A and group B(20.00% vs.10.00%,P>0.05),but the reinjection rate of group A was significantly higher than that of group B(41.67% vs.17.65%,P<0.05).Conclusion:Non-EMG guided Tenon's subcapsular injection of BTX-A can effectively relieve symptoms of congenital esotropia in children,and the curative effect is better when dose of BTX-A is not less than 2.5 U.

参考文献/References:

[1] Kelly KR,Felius J,Ramachandran S,et al.Congenitally impaired disparity vergence in children with infantile esotropia[J].Investigative Ophthalmology & Visual Science,2016,57(6):2545.
[2] 梅 芳,陈 娟,钱 晶,等.超常量内直肌后徙术治疗大角度先天性内斜视的疗效[J].实用医学杂志,2016,32(22):3686-3689.
[3] 钟华红,陈静嫦,麦光焕,等.肉毒杆菌毒素A水凝胶治疗婴幼儿型内斜视[J].中国实用眼科杂志,2016,34(8):868-871.
[4] 王贝贝,胡依博,王素萍,等.A型肉毒毒素在斜视治疗中的应用[J].中国斜视与小儿眼科杂志,2016,24(1):46-48.
[5] 艾立坤.肉毒毒素眼科应用的适应证及疗效[J].眼科,2016,25(5):289-293.
[6] 王文莹,吴 晓.A型肉毒毒素治疗先天性内斜视的疗效观察[J].眼科,2014,23(3):192-197.
[7] 梅 芳,钱 晶,陈 娟,等.手术时机对儿童先天性内斜视治疗效果的影响[J].中国医师杂志,2016,18(3):355-361.
[8] 税 丹,杨 君,曾 莉,等.非肌电图下肉毒毒素治疗先天性内斜视的观察与护理[J].中医眼耳鼻喉杂志,2018,8(1):48-50.
[9] 吴 倩,于 刚,李子江,等.小儿先天性内斜视临床特点及治疗[J].中国医刊,2007,42(8):65-66.
[10] 许 宇,亢晓丽,陈奕烨,等.伴有中枢性疾病的婴幼儿斜视临床特征[J].中华眼视光学与视觉科学杂志,2013,15(9):533-536.
[11] Carruthers JD,Carruthers A.Botulinum a exotoxin in clinical ophthalmology[J].Canadian Journal of Ophthalmology Journal Canadien Dophtalmologie,1996,31(7):389-400.
[12] Ing M,Costenbader FD,Parks MM,et al.Early surgery for congenital esotropia[J].American Journal of Ophthalmology,1966,61(6):1419-1427.
[13] 姚雪辉,张士宏,丁 洁.婴幼儿期外斜视术后眼位及双眼视功能的影响因素[J].国际眼科杂志,2016,16(9):1777-1779.
[14] 于 璐,李晓清,朱德海,等.婴幼儿期外斜视的手术时机及远期疗效[J].中华眼视光学与视觉科学杂志,2015,17(4):213-216.
[15] Austin E,Koo E,Jagdeo J.The cellular response of keloids and hypertrophic scars to botulinum toxin A:A comprehensive literature review[J].Dermatol Surg,2018,44(2):149-157.
[16] 张东亮,赵舒煊,王 明,等.A型肉毒毒素在神经系统疾病中的临床应用[J].临床与病理杂志,2018,38(7):1545-1551.
[17] Listed N.Botulinum toxin therapy of eye muscle disorders.Safety and effectiveness.American academy of ophthalmology[J].Ophthalmology,1989,9(2):37-41.
[18] 邵新香,司明宇,范可顺.肉毒素注射后上直肌移位联合改良肌联结术治疗麻痹性内斜视[J].中国斜视与小儿眼科杂志,2017,25(4):11-13.
[19] 张 燕,崔燕辉,白大勇,等.A型肉毒毒素治疗儿童斜视术后残余性斜颈的短期效果[J].眼科,2015,24(4):258-262.
[20] 赵 敏,孙 重.两种不同浓度的A型肉毒素注射治疗眼睑痉挛的观察对比[J].国际眼科杂志,2016,16(8):1587-1589.

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2021SF-336)
更新日期/Last Update: 2022-02-09