中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
6期
742-744
,共3页
眼睑痉挛%干眼%A型肉毒毒素
眼瞼痙攣%榦眼%A型肉毒毒素
안검경련%간안%A형육독독소
Blepharospasm%Dry eye%Botulinum toxin A
目的 探讨中重度眼睑痉挛患者的临床特征及治疗效果.方法 取病例为2009年1月至2010年12月在眼科门诊就诊的中重度眼睑痉挛患者34例,其临床资料包括眼部症状、泪河高度、基础泪液分泌实验(Schiemer Ⅰ test,S Ⅰ t)、泪膜破裂时间(break-up time,BUT)、角膜荧光素染色(fluorescent,F1).治疗方法选择A型肉毒毒素眼周注射联合人工泪液治疗,必要时加行泪点栓塞术,观察治疗效果并随访1年.结果 34例中20例中度(Ⅲ级)痉挛,14例为重度(Ⅳ级)痉挛,所有患者均主诉不自主频繁眨眼或眼周皮肤跳动,同时伴发眼干涩感、视疲劳、眼痒及视物模糊等症状.相关检查,泪河高度均小于0.3 nun,SⅠt≤5 mm者26例,5 mm＜S Ⅰ t≤10 mm者8例；BUT≤5 s者32例,5 s＜BUT≤10 s者2例；Fl染色评分为7.1±2.8；治疗后完全缓解者19例(55.9％),明显缓解15例(44.1％),有效率100％; 29.4％患者痉挛缓解维持时间4～6个月,32.4％为6～8个月,大于8个月者为38.2％.结论 大部分中重度眼睑痉挛合并有干眼,采用眼周皮下注射A型肉毒毒素,并坚持人工泪液治疗,必要时行泪点栓塞术对眼睑痉挛合并干眼不失为一条简单可行的有效方法.
目的 探討中重度眼瞼痙攣患者的臨床特徵及治療效果.方法 取病例為2009年1月至2010年12月在眼科門診就診的中重度眼瞼痙攣患者34例,其臨床資料包括眼部癥狀、淚河高度、基礎淚液分泌實驗(Schiemer Ⅰ test,S Ⅰ t)、淚膜破裂時間(break-up time,BUT)、角膜熒光素染色(fluorescent,F1).治療方法選擇A型肉毒毒素眼週註射聯閤人工淚液治療,必要時加行淚點栓塞術,觀察治療效果併隨訪1年.結果 34例中20例中度(Ⅲ級)痙攣,14例為重度(Ⅳ級)痙攣,所有患者均主訴不自主頻繁眨眼或眼週皮膚跳動,同時伴髮眼榦澀感、視疲勞、眼癢及視物模糊等癥狀.相關檢查,淚河高度均小于0.3 nun,SⅠt≤5 mm者26例,5 mm＜S Ⅰ t≤10 mm者8例；BUT≤5 s者32例,5 s＜BUT≤10 s者2例；Fl染色評分為7.1±2.8；治療後完全緩解者19例(55.9％),明顯緩解15例(44.1％),有效率100％; 29.4％患者痙攣緩解維持時間4～6箇月,32.4％為6～8箇月,大于8箇月者為38.2％.結論 大部分中重度眼瞼痙攣閤併有榦眼,採用眼週皮下註射A型肉毒毒素,併堅持人工淚液治療,必要時行淚點栓塞術對眼瞼痙攣閤併榦眼不失為一條簡單可行的有效方法.
목적 탐토중중도안검경련환자적림상특정급치료효과.방법 취병례위2009년1월지2010년12월재안과문진취진적중중도안검경련환자34례,기림상자료포괄안부증상、루하고도、기출루액분비실험(Schiemer Ⅰ test,S Ⅰ t)、루막파렬시간(break-up time,BUT)、각막형광소염색(fluorescent,F1).치료방법선택A형육독독소안주주사연합인공루액치료,필요시가행루점전새술,관찰치료효과병수방1년.결과 34례중20례중도(Ⅲ급)경련,14례위중도(Ⅳ급)경련,소유환자균주소불자주빈번잡안혹안주피부도동,동시반발안간삽감、시피로、안양급시물모호등증상.상관검사,루하고도균소우0.3 nun,SⅠt≤5 mm자26례,5 mm＜S Ⅰ t≤10 mm자8례；BUT≤5 s자32례,5 s＜BUT≤10 s자2례；Fl염색평분위7.1±2.8；치료후완전완해자19례(55.9％),명현완해15례(44.1％),유효솔100％; 29.4％환자경련완해유지시간4～6개월,32.4％위6～8개월,대우8개월자위38.2％.결론 대부분중중도안검경련합병유간안,채용안주피하주사A형육독독소,병견지인공루액치료,필요시행루점전새술대안검경련합병간안불실위일조간단가행적유효방법.
Objective To explore clinical characteristics and treatment of moderately severe blepharospasm.Methods Thirty-four patients with moderate to severe blepharospasm were recruited from our outpatient clinic from January 2009 to December 2010 as case group.The following items were recorded in these patients,including symptoms,slit-lamp examination,tear-up time,basal Schiemer test,fluorescent staining.These patients were treated with Botulinum toxin A injection combined with artificial tears,and lacrimal plug was applied in some severe patients,therapeutic effect were observed and post-treatment follow-up visits were performed.Results In 34 patients,20patients were moderate blepharospasm,while 14 were severe.All patients complained frequently involuntary blinks,and also complained about sensation of dryness,asthenopia,itching and blurred vision.Slit-lamp examination showed all patients' lacrimal river under 0.3mm,26 cases' Schiemer Ⅰ test equal or lower than 5mm,8 cases were between 5 and 10mm.BUT of 32 cases were equal or lower than 5s,while 2 cases were between 5 and 10s.The score of fluorescent staining were 7.1±2.8.After treatment,there was 55.9％ cases complete remission,44.1％ cases partial remission,efficiency rate was 100％.The duration of remission between 4-6 months were 29.4％ cases,between 6-8months were 32.4％,higher than 8 months were 38.2％.Conclusions Many patients with moderate to severe blepharospasm also suffer from dry eye.Botulinum toxin A injection combined with artificial tears,lacrimal plug as needed,is simple and effective in relieving blepharospasm and successful in treating dry eye syndrome.
