论文部分内容阅读
目的报告回顾性对列研究的结果:(1)肉毒杆菌毒素A唾液腺内注射治疗儿科流涎患儿的经验;(2)这些治疗干预的临床结果;(3)相关并发症发生率。设计回顾性队列研究;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,加拿大安大略省多伦多病儿在医院接受了肉毒杆菌毒素A唾液腺内注射。所有病儿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、病儿并发症、唾液黏稠度;照顾者对重复治疗的意愿、对治疗的满意度、对病儿治疗后生活质量的总评价。结果 45例病儿接受了91次肉毒杆菌毒素A治疗。作用持续时间平均为(4.6±5.2)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显著性(各自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(80%)照顾者报告本治疗改善了儿童生活质量。结论在对神经系统疾病所致儿童流涎的治疗中,超声引导下肉毒杆菌毒素A唾液腺内注射治疗为安全有效的方法。
PURPOSE To report the results of a retrospective pairwise study: (1) experience with intramuscular salivary botulinum toxin A in the treatment of children with salivation; (2) the clinical outcomes of these interventions; and (3) the incidence of related complications. Design retrospective cohort studies; Facilities City Children’s Hospital and Children’s Rehabilitation Center. 45 patients with neurological impairment in children. Treatment Interventions From January 2004 to May 2008, sick children in Toronto, Ontario, Canada, received botulinum toxin A salivary injection at the hospital. All sick children received either sedation or general anesthesia to complete botulinum toxin A injections under ultrasound guidance. MAIN OUTCOME MEASURES Post-treatment assessment includes duration of action, complications of sick child, saliva viscosity; caregiver’s willingness to repeat treatment, satisfaction with treatment, and overall quality of life after treatment. Results 45 patients received 91 botulinum toxin A treatments. Duration of action averaged (4.6 ± 5.2) months. The duration of effect (logarithmic transformation) was strongly negatively correlated with saliva volume (P = 0.02), but positively correlated with age and women, although neither was statistically significant (P = 0.08, respectively). 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 (80%) caregivers reported that this treatment improved children’s quality of life. Conclusion In the treatment of children with salvage due to nervous system diseases, ultrasound-guided injection of botulinum toxin A salivary gland is a safe and effective method.