Objective To investigate the effects of botulinum toxin type A (BTXA) on the excessive expansion speed and blood supply of myocutaneous flap. Methods Seven adult Guizhou minipigs of clean grade were included, female or male and weighing 16-20 kg. The 2.4 mL BTXA solution (96 U) was injected in cutaneous muscle (24 points) of one side as experimental group (n=7), the 2.4 mL saline in the other side as control group (n=7). Two expanders (200mL) were implanted beneath the cutaneous muscle on the bilateral flank of each pig symmertrically at 3 days after injection. One week later, the expanders were filled with saline every 4 days with an intracapsular pressure of 11.97 kPa, and accumulative total amounted to 400 mL for 3 weeks in control group and 5 weeks in experimental group. Then the expanders were taken out; the myocutaneous flaps formed and were sutured in situ. The myocutaneous flaps were cut for histological examination and capillary count. The expansion speed of the myocutaneous flap were recorded. The blood supply of the myocutaneous flap were observed by infrared thermography at 1 week after implantation expanders, before removing the expanders, and at 5 days after myocutaneous flap suture in situ. Results All the animals survived to the end of the experiment. The total expansion time was (54.0 ± 3.1) days in experimental group and (67.0 ± 3.9) days in control group, showing significant difference (t= —8.107, P=0.000). All myocutaneous flaps survived after being sutured in situ. Infrared thermograhy revealed that the temperature of the distal myocutaneous flap in experimental group was significantly higher than that in control group at 1 week after implantation of expanders (P lt; 0.05); at 5 days after myocutaneous flap suture in situ, the temperature of the central flap in experimental group was significantly higher than that in control group (P lt; 0.05); and there was no significant difference between 2 groups at the other time points (P gt; 0.05). The histological observation showed that the blood vessel density of the dermal layer and tissue between the capsule and the muscle layer in experimental group was significantly higher than those in control group (P lt; 0.05). Conclusion When excessive expansion is performed, BTXA can accelerate the expansion rate and improve the blood supply of expanded myocutaneous flaps.
目的:观察A型肉毒毒素(BTXA)对面肌痉挛(HFS)患者痉挛程度的改善和生存质量的影响。方法: 对68例HFS患者进行局部注射BTXA,治疗前及治疗后1个月分别对患者的痉挛程度进行判定和使用世界卫生组织生存质量评定量表简表(WHOQOL-BREF)评价生存质量。 结果: 97.04%的HFS患者在BXTA治疗后1个月痉挛明显改善缓解,而且患者在WHOQOL-BREF的生理领域、心理领域、社会关系领域、总的健康状况和总的生存质量的评分均明显高于治疗前,差异有统计学意义(Plt;0.01)。 结论: 局部注射BTXA可迅速缓解或消除HFS患者肌肉痉挛,提高患者的生存质量。