[1]何平,张江河,燕荣帅,等.注射性A型肉毒素中毒9例临床诊治分析[J].第三军医大学学报,2021,43(17):1684-1688.
 HE Ping,ZHANG Jianghe,YAN Rongshuai,et al.Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases[J].J Third Mil Med Univ,2021,43(17):1684-1688.
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注射性A型肉毒素中毒9例临床诊治分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
43卷
期数:
2021年第17期
页码:
1684-1688
栏目:
临床医学
出版日期:
2021-09-15

文章信息/Info

Title:
Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases
作者:
何平张江河燕荣帅樊东力王韶亮毛彤春李翔黄竞卓黄宇哲张一鸣
陆军军医大学(第三军医大学)第二附属医院整形外科
 
Author(s):
HE Ping ZHANG Jianghe YAN Rongshuai FAN Dongli WANG Shaoliang MAO Tongchun LI Xiang HUANG Jingzhuo HUANG Yuzhe ZHANG Yiming

Department of Plastic and Cosmetic Surgery, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China

关键词:
肉毒杆菌毒素类 A型中毒肉毒抗毒素
Keywords:
分类号:
R595.4; R971.92
文献标志码:
A
摘要:

目的探讨注射性A型肉毒素中毒的诊断指标及肉毒抗毒素对其治疗的效果。方法收集2018年8月至2020年12月本科收治的9例A型肉毒素中毒患者临床资料,包括血液实验室检查、电生理检查、眼科检查等结果,并分析肉毒抗毒素(A型)综合治疗效果。结果肉毒素中毒患者外周血液涂片可发现中性粒细胞胞内出现中毒颗粒;电生理检查有1例出现面神经运动传导潜伏时延长,1例出现三叉神经诱发电位延长,2例出现重复电刺激衰减,1例出现视觉诱发电位延长;眼科检查有2例复视图阳性,2例眼睑板腺检查部分缺失。9例患者经过肉毒抗毒素治疗,恢复情况良好。结论结合临床表现,全面的血液实验室检查、电生理检查及眼科检查有助于肉毒素中毒的早期诊断,对确诊肉毒素中毒患者应尽快使用肉毒抗毒素治疗。

Abstract:

ObjectiveTo explore the diagnostic criteria of botulism after botulinum toxin type A (BT/A) injection and observe the therapeutic effect of botulinum antitoxin. MethodsFrom August 2018 to June 2020, 9 patients suffering from botulism after BT/A injection admitted to our department were enrolled in this study. They all received blood laboratory examinations, electrophysiological examination, ophthalmological examination and so on, and then, were treated with botulinum antitoxin (type A). ResultsToxic granules in the neutrophils were found in the peripheral blood smears of these patients. The results of electrophysiological examination showed that there were prolongation of motor nerve conduction velocity (MCV) in 1 patient, prolongation of trigeminal somatosensory evoked potential (TSEP) in 1 patient, attenuation of repetitive nerve stimulation (RNS) in 2 patients and prolongation of visual evoked potential (VEP) in 1 patient. In ophthalmological examination, the double view was positive in 2 cases, and the eyelid plate gland was less in 2 cases. Nine patients were treated with botulinum antitoxin and recovered well after that. ConclusionCombined with clinical manifestations, comprehensive blood laboratory examinations, electrophysiological examination and ophthalmological examination are helpful for the early diagnosis and elimination of botulism. Patients with confirmed botulinum should be treated with botulinum antitoxin as soon as possible.

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更新日期/Last Update: 2021-09-03