CAJ | 학술논문

目的：探讨眶周肌肉切除术与A型肉毒毒素治疗眼睑痉挛的选择依据。 　　方法：回顾性分析2012-03/2014-05来我科诊治的特发性眼睑痉挛患者100例,根据眼睑痉挛的程度将其分成0~Ⅳ级,按分级分为两组：A 组为眼睑痉挛I~Ⅲ级患者60例,行A型肉毒毒素治疗；B组为眼睑痉挛>Ⅲ~Ⅳ级患者40例,采用眶周肌肉切除术治疗。术后随访3~24 mo。结果：A组60例患者行A型肉毒毒素注射后,57例患者眼睑痉挛分级为0级,完全矫正,2例注射后残留部分痉挛,但分级均明显下降,1例无效。 B组40例患者中有25例患者行肉毒毒素治疗已耐受,属复发性并伴有眉下垂和上睑下垂症状,均改行眶周肌肉切除术,患者行眶周肌肉切除术后,30例患者痉挛分级为0级,7例为I级,3例为Ⅱ级。 　　结论：根据眼睑痉挛的临床分级,正确选择特发性眼睑痉挛的治疗方法可提高治疗的有效性和安全性。
목적：탐토광주기육절제술여A형육독독소치료안검경련적선택의거。 　　방법：회고성분석2012-03/2014-05래아과진치적특발성안검경련환자100례,근거안검경련적정도장기분성0~Ⅳ급,안분급분위량조：A 조위안검경련I~Ⅲ급환자60례,행A형육독독소치료；B조위안검경련>Ⅲ~Ⅳ급환자40례,채용광주기육절제술치료。술후수방3~24 mo。결과：A조60례환자행A형육독독소주사후,57례환자안검경련분급위0급,완전교정,2례주사후잔류부분경련,단분급균명현하강,1례무효。 B조40례환자중유25례환자행육독독소치료이내수,속복발성병반유미하수화상검하수증상,균개행광주기육절제술,환자행광주기육절제술후,30례환자경련분급위0급,7례위I급,3례위Ⅱ급。 　　결론：근거안검경련적림상분급,정학선택특발성안검경련적치료방법가제고치료적유효성화안전성。
AIM: To investigate the choice basis of orbital muscle excision and botulinum toxin A injection in the treatment of blepharospasm. METHODS: This retrospective clinical analysis was involved 100 cases with idiopathic blepharospasm. According to the degree of blepharospasm, they were divided into 0-Ⅳ grade, and divided into two groups. Group A included 60 cases (I ~ Ⅲ grade ) treated with botulinum toxin A, and 40 cases (>Ⅲ~Ⅳgrade) in group B treated with orbital muscle excision during the period from March 2012 to May 2014 in our hospital. Patients were followed up 3 ~ 24mo. RESULTS: In 60 cases of group A, After treatment, 57 patients were completely corrected with classified grade of 0, 2 patients residue spasm, but its grade was decreased significantly, and 1 case had no effect. Of 40 patients in group B were in grade>Ⅲ ~ Ⅳ, 25 patients were poor response to botulinum toxin treatment and accompanied with drooping eyebrow and eyelid ptosis symptoms. Thirty patients were completely corrected after injection, 7 residue cases were in grade I, 3 cases in grade II. CONCLUSION: The correct choice of the treatment for blepharospasm according to the clinical classification can improve the efficacy and safety.