本文選題：A型肉毒毒素 + 痙攣性斜頸　； 參考：《蘇州大學》2014年碩士論文

【摘要】：目的：探討發(fā)病年齡、性別、病程等因素對A型肉毒毒素治療痙攣性斜頸的長期有效性的影響。 方法：選擇2009年1月至2012年8月期間,在蘇州大學附屬第二醫(yī)院診斷為痙攣性斜頸的患者54例，在肌電圖引導下行胸鎖乳突肌、頭夾肌、頸夾肌、斜方肌、肩胛提肌、斜角肌等頸部肌肉多點局部注射治療，在治療前、治療后半月、1月、3月、6月、18月、42月進行電話或門診復診隨訪，并以末次注射后18個月的療效來分析發(fā)病年齡、病程（發(fā)病至首次A型肉毒素治療時間）、性別、臨床分型、病情嚴重程度等因素對A型肉毒毒素治療的長期效果的影響，同時進行安全性觀察。 結果：47例患者完成了最終隨訪，其中31例患者經過1次A型肉毒毒素注射治療，21例(68%)有效，16例經過2次及2次以上的A型肉毒毒素注射治療，13例(81%)有效；年齡＜45歲31例，26例有效(84%)有效，≥45歲16例，，8例(50%)有效，年齡＜45歲組療效顯著優(yōu)于年齡≥45歲組（P=0.020）；病程＜3年33例，27例(82%)有效，≥3年14例，7例(50%)有效，病程＜3年組療效顯著優(yōu)于病程≥3年組（P=0.026）；性別、臨床分型、病情嚴重程度對A型肉毒毒素的療效無顯著性的影響（P=0.664，P=0.596，P=0.693）。 47例患者中15例出現(xiàn)頸部無力，4例出現(xiàn)吞咽困難，1例出現(xiàn)流感樣癥狀，2例出現(xiàn)頸痛，均自然緩解。 結論：A型肉毒毒素長期治療痙攣性斜頸是有效和安全的，發(fā)病年齡、病程對A型肉毒毒素治療痙攣性斜頸的療效有顯著的影響。
[Abstract]:Objective: to investigate the effects of age, sex and course of disease on the long-term efficacy of botulinum toxin type A in the treatment of spastic torticollis. Methods: from January 2009 to August 2012, 54 cases of spasmodic torticollis were diagnosed in the second affiliated Hospital of Suzhou University. The sternocleidomastoid muscle, cephalocephalic muscle, cervical clip muscle, trapezius muscle, levator scapularis muscle were guided by electromyography (EMG). Scalene muscle and other cervical muscles were treated by multi-point local injection. The patients were followed up by telephone or outpatient for half a month, one month, three months, six months, eighteen months and forty-two months after treatment, and the age of onset was analyzed by 18 months after the last injection. Effects of course of disease (from onset to first botulinum toxin A treatment time, sex, clinical type, severity of illness, etc.) on the long-term efficacy of botulinum toxin A treatment were observed at the same time. Results the final follow-up was completed in 47 cases. Among them, 31 cases were treated with botulinum toxin A injection (21 cases). 16 cases were treated with botulinum toxin A injection for 2 times and more than 2 times. 13 cases were treated with botulinum toxin A injection (n = 13). Age < 45 years 31 cases (26 cases) effective), age 鈮

本文編號：2017070