CAJ | 학술논문

目的探讨无需肌电仪引导的A型肉毒素(BTA)联合或不联合透明质酸钠注射治疗外伤性外展神经麻痹的有效性及安全性.方法前瞻性随机对照临床研究.采用抽签法将入选的27例年龄≥16岁病程＜6个月的外伤性外展神经麻痹患者随机分成2组,A组无需肌电仪引导直视下行患眼内直肌注射0.05 ml BTA 2.5～7.5 U联合透明质酸钠;B组无需肌电仪引导直视下行患眼内直肌注射0.03 ml BTA溶液2.5～7.5 U.分别于注射前、注射后2周、6个月测定患者斜视度、眼球运动功能及睑裂大小.数据采用配对t检验、独立样本t检验和卡方检验.结果 2组患者在注射后2周均出现斜视度明显下降(t=8.75、8.79,P均＜0.01);A、B组的治愈率分别为62％及71％,2组比较差异没有统计学意义(x2＝0.297,P＞0.05);A、B组均未出现并发性上睑下垂及垂直斜视.结论无需肌电仪引导的肉毒素联合或不联合透明质酸钠注射均能有效治疗外伤性外展神经麻痹,而且有较好的安全性.
목적 탐토무수기전의인도적A형육독소(BTA)연합혹불연합투명질산납주사치료외상성외전신경마비적유효성급안전성.방법 전첨성수궤대조림상연구.채용추첨법장입선적27례년령≥16세병정＜6개월적외상성외전신경마비환자수궤분성2조,A조무수기전의인도직시하행환안내직기주사0.05 ml BTA 2.5～7.5 U연합투명질산납;B조무수기전의인도직시하행환안내직기주사0.03 ml BTA용액2.5～7.5 U.분별우주사전、주사후2주、6개월측정환자사시도、안구운동공능급검렬대소.수거채용배대t검험、독립양본t검험화잡방검험.결과 2조환자재주사후2주균출현사시도명현하강(t=8.75、8.79,P균＜0.01);A、B조적치유솔분별위62％급71％,2조비교차이몰유통계학의의(x2＝0.297,P＞0.05);A、B조균미출현병발성상검하수급수직사시.결론 무수기전의인도적육독소연합혹불연합투명질산납주사균능유효치료외상성외전신경마비,이차유교호적안전성.
Objective To evaluate the efficacy and safety of botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of traumatic sixth nerve palsy.Methods In this prospective,comparative,interventional case series,27 patients with traumatic sixth nerve palsy who was older than 16 years old and presented within 6 months of trauma were randomly divided into 2 groups by drawing lots.In group A,13 cases were treated with an injection of 2.5-7.5 U BTA combined with sodium hyaluronate in the antagonist medial rectus muscle.In group B,14 cases were treated with an injection of 2.5-7.5 U BTA solution alone in the antagonist medial rectus muscle.Electromyography was not used in the study.All patients were evaluated preoperatively and 2 weeks and 6 months following the injections.Data were analyzed using paired t test,independent t test and chi-square test.Results The size of deviation was significantly reduced 2 weeks following the injections in both groups (t=8.75,P＜0.01 in group A,t=8.79,P＜0.01 in group B).The recovery rate in groups A and B were 62％ and 71％ respectively,which had no statistical significance (x2=0.297,P＞0.05).No ptosis or vertical deivation was encountered in both groups.Conclusion BTA injections combined with or without sodium hyaluronate in the absence of electromyography demonstrated effectiveness and safety in the treatment of traumatic sixth nerve palsy.