A型肉毒素注射与眶周全肌切除术治疗特发性眼睑痉挛的比较

Comparison of effects of botulinus toxin of type A and complete resection of the periorbital muscle for idiopathic blepharospasm

摘要:

目的：比较A型肉毒素注射与眶周全肌切除术治疗特发性眼睑痉挛的疗效。

方法：前瞻性非随机对照试验。选取2010-12/2015-06间在我院实施A型肉毒素注射治疗的特发性眼睑痉挛患者30例60眼，同时选取年龄匹配的眶周全肌切除术治疗的特发性眼睑痉挛患者30例60眼，随访观察6mo，比较两组的疗效和复发率。

结果：A型肉毒素注射治疗组完全缓解、明显缓解、部分缓解和无效的眼数分别为36眼(60.0%)，20眼(33.3%)、2眼(3.3%)和2眼(3.3%)。眶周全肌切除术治疗组为16眼(26.7%)，24眼(40.0%)、12眼(20.0%)和8眼(13.3%)，两组比较差异有统计学意义(Z=-2.968， P=0.003)。治疗6mo后两组的复发率为93.3%和20.0%，比较差异有统计学意义( χ²=32.851， P<0.001)。

结论：A型肉毒素注射治疗对于特发性眼睑痉挛疗效好，但6mo后容易复发。眶周全肌切除术疗效确定且长期疗效稳定，可作为A型肉毒素注射治疗后复发的有效治疗途径。

Abstract:

AIM: To compare the effectiveness of botulinus toxin of type A and complete resection of the periorbital muscle on idiopathic blepharospasm.

METHODS: Patients with idiopathic blepharospasm and having undergone either of two procedures from Dec. 2010 to Jun. 2015 were selected(60 patients). Among them, group A(30 patients, 60 eyes)underwent botulinus toxin of type A, group B(30 patients, 60 eyes)underwent complete resection of the periorbital muscle.

RESULTS: In group A, the patients with complete response, obvious response, partial response, and no response were 36(60.0%), 20(33.3%), 2(3.3%)and 2(3.3%)cases respectively. In group B, the patients with complete response, obvious response, partial response, and no response were 16(26.7%), 24(40.0), 12(20.0%)and 8(13.3%)cases respectively. The difference was statistically significant(Z=-2.968, P=0.003). The relapse rate of group A and group B were 93.3% and 20.0% after 6mo, the difference was statistically significant(χ²=32.851, P<0.001).

CONCLUSION: The botulinus toxin injection of type A is effective for idiopathic blepharospasm. But recurrence rate is high after 6mo. Complete resection of the periorbital muscle have long-term efficacy for idiopathic blepharospasm. It's a supplementary therapy after idiopathic blepharospasm recurrence.