380例注射肉毒毒素美容中毒患者的临床分析

来源 :中华急诊医学杂志 | 被引量 : 0次 | 上传用户:guangtoucx
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目的:分析总结注射肉毒毒素美容中毒患者的基本特点及临床特征。方法:采用回顾性调查分析方法,对2016.03至2019.06全军中毒救治中心接诊的注射肉毒毒素美容中毒患者资料进行描述性分析。结果:本研究共入选病例380例,其中住院治疗114例,急诊留观治疗266例。以女性为主(97.4%),30~39岁年龄段最多(39.5%),发生场所主要在美容院或美容工作室,注射的肉毒毒素多为假冒伪劣产品。发病潜伏期主要分布在3~6 d,常见的临床表现有头晕、视物模糊、双眼睁眼无力、吞咽困难、胸闷憋气、乏力、复视、恶心、眼睑下垂、构音障碍等,颅神经损伤“4D”征同时出现的较少,以轻、中度中毒为主;住院病例中,构音障碍、吞咽困难、双眼睁眼无力、视物模糊、饮水呛咳、咀嚼无力、双侧眼睑下垂、四肢肌力减退、乏力以及胸闷憋气所占比例明显高于急诊病例(n P均小于0.05)。有309例接受了肉毒抗毒素治疗,急诊病例中,使用剂量2(2~3)万U,总治疗时间4(3~7) d;住院病例中,使用剂量3(3~5)万U,总治疗时间8(5~11) d,均显著高于急诊病例(n P<0.05)。所有病例的随访预后均良好。n 结论:注射肉毒毒素美容有一定的风险,出现头晕、视物模糊、睁眼无力、吞咽困难等中毒症状后应及时就医,尽早给予肉毒抗毒素治疗可促进病情的恢复。“,”Objective:To analyze and summarize the basic characteristics and clinical features of botulism patients caused by cosmetic injection of botulinum toxin.Methods:Retrospective investigation and analysis method were used to analyze the data of botulism patients caused by cosmetic injection of botulinum toxin admitted to the Poisoning Treatment Center of the PLA from March 2016 to June 2019.Results:Total of 380 cases were included in this study, including 114 hospitalized cases and 266 emergency cases. The majority patients (97.4%) were female, and most of them (39.5%) were among 30-39 years old. Most of the cases occurred in beauty salons or beauty studios, and most of the botulinum toxin injected was fake and inferior products. Onset latency were mainly distributed in 3 to 6 days. Common clinical symptoms included dizziness, blurred vision, eyes open weakness, dysphagia, chest tightness of breath, fatigue, diplopia, nausea, bilateral eyelid drooping, and dysarthria. The “4D” sign of cranial nerve injury occurred less frequently, mainly with mild and moderate poisoning; The occurrence rates of dysarthria, dysphagia, eyes open weakness, blurred vision, choking in drinking water, chewing weakness, bilateral eyelid drooping, decreased limb muscle strength, and chest tightness of breath in the hospitalized case were significantly higher than those in the emergency cases (all n P < 0.05). Three hundred and nine patients received botulinum antitoxin therapy. The dose of botulinum antitoxin was 20 000 (20 000-30 000) U, with a total treatment duration of 4 (3-7) days in the emergence cases, and 30 000 (30 000-50 000) U with a total treatment time of 8 (5-11) days in the hospitalized cases, and there were significant differences between the two groups ( n P < 0.05). All cases were followed up with good prognosis.n Conclusions:Cosmetic injection of botulinum toxin has certain risk. If symptoms of poisoning occur such as dizziness, blurred vision, eyes open weakness and dysphagia, patients should be treated promptly, and early treatment with botulinum antitoxin can improve the prognosis.
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