注射性A型肉毒素中毒9例临床诊治分析

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

doi:10.16016/j.1000-5404.202103069

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注射性A型肉毒素中毒9例临床诊治分析

临床医学 | 更新时间：2026-01-09

- 注射性A型肉毒素中毒9例临床诊治分析
- Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases
- 第三军医大学学报 2021年43卷第17期页码：1684-1688
- 作者机构：
- 作者简介：
- 基金信息：
  
  重庆市科卫联合医学科研项目(2019MSXM013)
- DOI：10.16016/j.1000-5404.202103069
  中图分类号：
- 收稿：2021-03-07，
  
  纸质出版：2021-09-15
- 稿件说明：
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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.

Ping HE, Jianghe ZHANG, Rongshuai YAN, et al. Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases[J]. Journal of Third Military Medical University, 2021, 43(17): 1684-1688.
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. DOI： 10.16016/j.1000-5404.202103069.

Ping HE, Jianghe ZHANG, Rongshuai YAN, et al. Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases[J]. Journal of Third Military Medical University, 2021, 43(17): 1684-1688. DOI： 10.16016/j.1000-5404.202103069.

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

Objective

To explore the diagnostic criteria of botulism after botulinum toxin type A (BT/A) injection and observe the therapeutic effect of botulinum antitoxin.

Methods

From 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).

Results

Toxic 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.

Conclusion

Combined 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.

关键词

Keywords

references

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