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目的 (1)报告我们的经验,即对儿科流涎病人进行肉毒杆菌毒素A唾液腺内注射;(2)这些治疗干预的临床结果及相关并发症发生率。设计回顾性定群研究。设施城市儿童医院和儿童康复中心。病人45例神经受损儿童。治疗干预2004年1月—2008年5月,对加拿大安大略省多伦多的病人进行了医院内肉毒杆菌毒素A唾液腺内注射。所有病人都接受了镇静或全麻以便在超声波引导下完成肉毒杆菌毒素A注射。主要结果测量治疗后评估包括:作用持续时间、并发症、唾液黏稠度;照顾者对重复治疗的意愿、对治疗的满意度、病人治疗后生活质量的总评价。结果 45例受试者接受了91次肉毒杆菌毒素A治疗。作用持续时间平均为4.6个月。作用持续时间(对数转化)与唾液量呈强负相关(P=0.02),而与年龄增长和女性呈正相关,尽管两者均未达统计学差异(P=0.08)。根据协会放射学分类系统并发症结果量表测试结果,有24例出现并发症,严重者7例。36位照顾者报告本治疗改善了儿童生活质量(80%)。结论在儿童神经性障碍流涎管理中,超声引导下肉毒杆菌毒素A唾液腺内注射为安全有效的方法。
Objectives (1) To report our experience with botulinum toxin A salivary gland injection in pediatric salivary patients; (2) clinical outcomes of these therapeutic interventions and associated complication rates. Design retrospective population study. Facilities City Children’s Hospital and Children’s Rehabilitation Center. 45 patients with neurological impairment in children. Treatment Interventions Intra-hospital botulinum toxin A salivary injection was performed on patients from Toronto, Ontario, Canada, January 2004-May 2008. All patients received sedation or general anesthesia to complete botulinum toxin A injections under ultrasound guidance. MAIN OUTCOME MEASURES Post-treatment assessment includes duration of action, complications, salivary viscosity, willingness of caregivers to repeat treatment, satisfaction with treatment, and overall quality of life after treatment. Results 45 subjects received 91 botulinum toxin A treatments. Duration of action averaged 4.6 months. The duration of effect (logarithmic transformation) was strongly negatively correlated with salivary volume (P = 0.02), but positively correlated with age and women, although not statistically significant (P = 0.08). According to the Association radiology classification system complication outcome scale test results, there were 24 cases of complications, in severe cases in 7 cases. Thirty-six caregivers reported that this treatment improved children’s quality of life (80%). Conclusions Ultrasound-guided intramuscular injection of botulinum toxin A salivary gland is a safe and effective method for salvage management of children with neurological disorders.