眼科 ›› 2015, Vol. 24 ›› Issue (4): 258-262.doi: 10.13281/j.cnki.issn.1004-4469.2015.04.010

• 论著 • 上一篇    下一篇

A型肉毒毒素治疗儿童斜视术后残余性斜颈的短期效果

张燕  崔燕辉  白大勇  刘丽丽  于刚   

  1. 100045首都医科大学附属北京儿童医院眼科
  • 收稿日期:2014-08-24 出版日期:2015-07-25 发布日期:2015-08-18
  • 通讯作者: 于刚,Email:ykyg0202@vip.163.com

The short-term efficacy of injection of botulinum toxin type A for the treatment of residual torticollis after children strabismus surgery

HANG Yan, CUI Yan-hui, BAI Da-yong, LIU Li-li, YU Gang.   

  1. Department of Ophthalmology, Beijing Children’s Hospital, Beijing 100045, China.
  • Received:2014-08-24 Online:2015-07-25 Published:2015-08-18
  • Contact: Corresponding author: YU Gang, Email: ykyg0202@vip.163.com

摘要:

目的 观察颈部注射A型肉毒毒素(BTX-A)治疗儿童斜视术后残余性斜颈的效果。设计 回顾性病例系列。研究对象 21例10岁以下因上斜肌不全麻痹行斜视矫正术后3个月以上仍存在代偿头位的患儿。方法 对残余性斜颈患儿采用体表标记定位、徒手注射法进行颈部BTX-A注射2~8个位点,总量控制在4~8 U/kg。使用头位测量仪测量患儿注射A型肉毒毒素后的头位变化,并记录家长对患儿头位改变的主观观察结果。随诊3~6个月。主要指标 头位侧屈度数及家长主观评价。结果 颈部注射BTX-A后3个月,38.1%患儿头位侧屈度数轻微改善,9.5%显著改善;家长对注射BTX-A后患儿斜颈改善情况主观评价,57.1%轻微改善,9.5%显著改善。结论 短期随访研究显示,颈部注射BTX-A治疗儿童残余性斜颈效果有限。(眼科,2015,24:258-262)

关键词: 斜颈, A型肉毒毒素, 非共同性斜视

Abstract:

【Abstract】 Objective To observe the short-term effect of injection of botulinum toxin type A (BTX-A) in neck muscles for treatment in residual torticollis after strabismus surgery. Design Retrospective case series. Participants The 21 children with residual torticollis more than 3 months after superior oblique incomplete paralysis surgery. Methods BTX-A injections in neck muscles were performed in 21cases with residual torticollis after strabismus surgery. Before the injection, target muscles were fixed by surface markers. Injection dose is with 4-8 U/kg and administrated at 2-8 points. Head position was measured with head position measuring instrument. And the parents’ feelings about these children’ head position were recorded too. Follow up time is 3-6 months. Main Outcome Measures Measured head position and parents’ assessment of these children’ head position. Results 3 month after BTX-A injection, mild amelioration of torticollis were presented in 38.1% of children, and significant amelioration was 9.5%. According to parents’ assessment, 57.1% children had mild amelioration and 9.5% had significant amelioration. Conclusions Short-term observation suggests injection of BTX-A in neck muscles has a limited effect in treatment of residual torticollis. (Ophthalmol CHN, 2015, 24: 258-262)

Key words: torticollis, botulinum toxins type A, noncomitant strabismus