摘要
目的分析颈项部肌内局部注射A型肉毒毒素(BTX-A)、肌内乙醇阻滞(MAB)和局部封闭联合方案治疗痉挛性斜颈的临床特点、疗效、预后以及长期随访。方法回顾性分析2004年5月至2021年10月在安徽中医药大学神经病学研究所附属医院就诊,明确诊断为痉挛性斜颈并采用BTX-A、MAB以及封闭疗法联合治疗的病人的临床资料,在治疗前后行Tsui量表、全面肌张力障碍量表(FMRS)评估疗效,出院后进行长期随访调查和36项简明健康问卷调查(SF-36)。按随访结果将病人分为症状复发组和症状未复发组,比较各临床因素同临床结果之间的关系。结果14例病人中,男性4例,女性10例,年龄范围为18~47岁。Tsui量表治疗前为(11.86±4.37)分,治疗后为(1.07±0.92)分,治疗后评分显著降低(P<0.01);Tsui量表提示13例病人症状为完全缓解,1例为明显缓解。FMRS治疗前为(8.21±3.62)分;治疗后为(0.89±0.86)分,治疗后评分显著降低(P<0.01)。随访结果表明14例病人中4例长期随访至今未曾复发;6例复发,疗效维持时间均>14个月;4例随访丢失。病人出院半年后进行SF-36健康状况问卷调查,显示随访到的10例病人9项得分均>80.3分,提示生命质量较高,预后较好。按随访结果分组,两组年龄、性别、病程、身体质量指数(BMI)、临床分型、BTX-A剂量、BTX-A注射次数、封闭次数比较,差异无统计学意义(P>0.05);两组治疗前Tsui评分、MAB注射次数比较,差异有统计学意义(P<0.05)。结论BTX-A、MAB联合局部封闭疗法治疗痉挛性斜颈病人疗效显著,维持时间较长,未见明显并发症,值得临床上进一步扩大样本量进行对比分析等系列研究与推广应用。
Objective To analyze the clinical characteristics,efficacy,prognosis,and long-term follow-up of local injection of botuli⁃num toxin type A(BTX-A),muscle alcohol block(MAB)and local blocking combined regimen into the nuchal muscles in the treatment of spasmodic torticollis.Methods The clinical data of patients with spasmodic torticollis who were diagnosed as spasmodic torticollis and treated with BTX-A,MAB,and blocking therapy in the Affiliated Hospital of Institute of Neurology,Anhui University of Traditional Chinese Medicine from May 2004 to October 2021 were retrospectively analyzed.The Tsui scale and Fahn Marsden Rating Scale(FMRS)were performed before and after treatment to assess efficacy.A long-term follow-up survey and 36-item Short-From-36 Health Survey(SF-36)were performed after discharge.According to the follow-up results,the patients were assigned into the symptom recur⁃rence group and symptom non-recurrence group to compare the relationship between each clinical factor and clinical results.Results Of the 14 patients,4 were male and 10 were female,aged 18-47 years.The mean score on the Tsui scale was(11.86±4.37)points be⁃fore treatment and(1.07±0.92)points after treatment,and the score was significantly reduced after treatment(P<0.01);the Tsui scale revealed complete remission of symptoms in 13 patients and significant remission in 1 patient.The mean score of FMRS was(8.21±3.62)points before treatment and(0.89±0.86)points after treatment,and the score significantly decreased after treatment(P<0.01).The follow-up results showed that 4 of 14 patients had no recurrence after long-term follow-up,6 patients had a recurrence,and the duration of efficacy was more than 14 months;4 patients were lost during follow-up.Six months after discharge,the SF-36 health status question⁃naire showed that the scores of 9 items of 10 patients were more than 80.3 points,indicating higher quality of life and better prognosis.According to the follow-up results,there was no significant difference in age,gender,cours
作者
陈明长
高伟明
胡文彬
CHEN Mingzhang;GAO Weiming;HU Wenbin(Department of Graduate School,Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230001,China;Department of Neurology,Affiliated Hospital of Neurological Institute,Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230001,China)
出处
《安徽医药》
CAS
2024年第5期992-998,共7页
Anhui Medical and Pharmaceutical Journal
关键词
斜颈
A型肉毒毒素
肌内乙醇阻滞
局部封闭
疗效
Torticollis
Botulinum toxin type A
Muscle alcohol block
Local block
Efficacy
