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目的探讨A型肉毒毒素治疗面肌痉挛的疗效及不良反应。方法对121例面肌痉挛患者进行面肌多点注射A型肉毒杆菌毒素,对治疗前后的病情分级进行比较,并随访3～12月。结果A型肉毒杆菌毒素治疗的总有效率为100%,绝大多数局部不良反应轻微、短暂,但极少数可能出现不可逆的局部面肌萎缩,偶见全身不良反应。3个月复发率为80%,药效作用时间平均为5月,重复注射仍然有效。结论局部注射A型肉毒杆菌毒素是治疗面肌痉挛的一种有效手段,准确定位、注射合适剂量是本治疗方法的关键所在,且注射剂量应遵循个体化原则。
Objective To investigate the efficacy and adverse reactions of botulinum toxin type A in the treatment of hemifacial spasm. Methods A total of 121 hemifacial spasm patients were injected with botulinum type A botulinum toxin type A repeatedly before and after treatment. The patients were followed up for 3 to 12 months. Results The total effective rate of botulinum toxin type A treatment was 100%. The vast majority of local adverse reactions were mild and transient. However, a very small number of patients may have irreversible local facial muscle atrophy and occasionally systemic adverse reactions. The recurrence rate was 80% at 3 months, and the average duration of the effect was 5 months. Repeated injections were still effective. Conclusion Local injection of botulinum toxin type A is an effective method for the treatment of hemifacial spasm. Accurate positioning and injection of the appropriate dose are the key points of this treatment method. The injection dose should follow the principle of individualization.