Botulinum toxin yog ib qho tshuaj lom uas tsim los ntawm cov kab mob Clostridium botulinum, nrov npe hu ua Botox. Nws yog siv tsis tau tsuas yog nyob rau hauv cov tshuaj aesthetic, tab sis kuj, nyob rau hauv particular, nyob rau hauv neurology. Nws yog ib qho tshuaj lom uas muaj zog heev, txawm li cas los xij, siv me me, nws muaj kev nyab xeeb kiag li.
Dab tsi yog botulinum toxin?
Botulinum toxin yog ib yam khoom tsim los ntawm cov kab mob anaerobic Clostridium botulinum. Nws yog tsim nyob rau hauv cov av, sediment, thiab tsis tsim nyog npaj thiab khaws cia nqaij thiab zaub kaus poom. Kev noj cov kaus poom zoo li no tuaj yeem ua rau botulism. Nws muaj qhov tsis zoo rau cov ntaub so ntswg neuromuscular thiab cuam tshuam rau cov leeg. Cov khoom no yog rhiab heev rau qhov kub thiab txias (decomposes ntawm qhov kub siab tshaj 60o).
Muaj ntau hom tshuaj lom no, uas tau xaiv los ntawm cov ntawv los ntawm A mus rau G. Txhawm rau txhim kho cov tsos, nws yog siv hauv cov tshuaj me me uas tsis ua rau muaj kev phiv.teebmeem. Botulinum toxin type A yog siv hauv tshuaj kho kom zoo nkauj.
Tshuaj lom los ntawm cov tshuaj no tsawg dua li yav dhau los. Qhov no yog vim qhov tseeb tias cov zaub mov tau pib khaws cia rau hauv cov xwm txheej zoo dua. Thaum muaj peev xwm ua rau muaj tshuaj lom nrog cov tshuaj lom no, yuav tsum tau ua lub plab zom mov thiab yuav tsum tau noj cov tshuaj laxative kom tshem tawm cov co toxins ntau li ntau tau los ntawm txoj hnyuv. Thaum muaj tshuaj lom, tus neeg mob tau txais tshuaj antiotoxin (anti-botulinum serum). Nws yog ib qho tseem ceeb heev kom tswj tau lub cev kom zoo thiab noj zaub mov zoo thaum kho.
Tseem muaj cov tshuaj lom nkag mus rau hauv lub qhov txhab, piv txwv li, los ntawm av. Nyob rau hauv tas li ntawd, kev phais ntxuav lub qhov txhab thiab tshuaj tua kab mob yuav tsum tau.
Mechanism of action of botulinum toxin
Lub tshuab ua haujlwm ntawm cov tshuaj no yog thawj zaug siv los kho cov kab mob neurological thiab ophthalmic. Cov tshuaj lom tau siv, tshwj xeeb, txhawm rau txo cov leeg nqaij ntau dhau rau cov menyuam yaus uas muaj mob hlwb, lossis cov neeg uas muaj mob stroke. Thaum lawv pib kho strabismus nrog nws, nws tau pom tias nws tsis tsuas yog txhim kho qhov muag, tab sis kuj smoothes wrinkles. Los ntawm kev sim thiab ua yuam kev, cov kws kho mob tau tsim ntau npaum li cas, nrog rau cov kev txhaj tshuaj. Nyob rau hauv lub 80s ntawm lub xyoo pua xeem, cov tshuaj tau pib siv nyob rau hauv aesthetic dermatology. Nws yog qhov chaw nrov heev.
Botulinum toxin type A ua rau muaj kev tawm tsam ntawm kev tso tawm ntawm acetylcholine, neurotransmitter lub luag haujlwm rau kev tsim cov impulses ntawm cov hlab ntsha thiab cov leeg. Nws ua haujlwm los ntawm kev thaiv kev sib txuas ntawm cov hlab ntshaqhov kawg thiab cov leeg, uas yog, nws thaiv qhov hu ua neuromuscular synapses. Botulinum toxin khi rau daim nyias nyias ntawm presynaptic receptors thiab thaiv kev tso tawm ntawm acetylcholine. Qhov no ua rau lub fact tias cov nqaij ntshiv so, thiab wrinkles yog smoothed tawm ib pliag. Cov txheej txheem no yog siv hauv tshuaj.
Nyob rau hauv cov kab mob xws li strabismus, neurological pathologies uas tshwm sim nrog ntau cov leeg nqaij, hyperhidrosis, ntsej muag wrinkles, botulinum toxin yog siv. Cov tshuaj nrog cov tshuaj no ua haujlwm hauv zos, tab sis txij li cov paj hlwb muaj peev xwm tsim cov kev sib txuas tshiab, cov nyhuv kho tau txo qis thiab ploj mus 4-6 lub hlis tom qab txhaj tshuaj lom. Yog li ntawd, cov txheej txheem yuav tsum rov ua dua.
Cov tshuaj siv hauv cov tshuaj yog kuaj-tsim los ntawm cov kab mob sib cais, ua kom huv thiab muab tso rau hauv lub tshuab nqus tsev ntim hauv cov koob tshuaj nruj me ntsis. Lawv siv tau zoo thiab muaj txiaj ntsig hauv ntau thaj chaw tshuaj.
Nyob rau hauv aesthetic dermatology, kom du tawm wrinkles, koob ntawm qhov kev txiav txim ntawm 20-60 units yog siv nyob rau hauv ib tug txheej txheem. Lawv toxicity yog tawm ntawm lo lus nug, txij li thaum cov tshuaj lom rau tib neeg yog los ntawm 2.5 mus rau 3 txhiab units.
Siv hauv dermatology
Botulinum toxin type A-hemagglutinin complex (Botulinum toxin type A - hemagglutinin complex) paub hauv cov tshuaj zoo nkauj raws li cov npe tshuaj "Botox", "Dysport", "Xeomin"
Yuav kom cov tshuaj nrog cov tshuaj no pib nws qhov kev ua, nws yuav tsum tau txhaj rau hauv cov leeg tshwj xeeb. Botulinum toxin txhaj tshuaj tiv thaiv neuromuscular conduction, tiv thaiv cov leeg nqaij spasm thiab ua rau lawv so. Thaum kawg, cov nyhuv zoo nkauj zoo nkauj tau txais, uas yog, tom qab cov leeg so, cov wrinkles me me tsis pom. Tsis tas li ntawd, cov wrinkles uas twb muaj lawm yuav tsis ua kom tob, uas yog ib hom kev tiv thaiv uas tso cai rau koj kom ncua cov hluas. Tsis tas li ntawd, cov neeg uas nws cov wrinkles tseem tsis tau pom tuaj yeem siv botulinum toxin. Nws daim ntawv thov raws sij hawm yuav pab ua kom cov tawv nqaij ntawm lub ntsej muag ntev ntev thiab du. Qhov no tsis tau txhais hais tias cov hluas yuav tsum tau ua raws li cov txheej txheem. Kev taw qhia ntawm botulinum toxin yog nqa tawm tsuas yog tom qab kev sab laj nrog tus kws kho mob tshwj xeeb. Tus kws kho mob yuav tsum piav qhia rau tus neeg mob tias cov txheej txheem yuav ua li cas, tham txog qhov tshwm sim thiab cov kev mob tshwm sim tuaj yeem tshwm sim. Qhov kev txiav txim zaum kawg los ua txoj haujlwm yuav tsum ua kom tus neeg mob paub meej.
Cov lus qhia rau kev siv
Cov tshuaj no feem ntau siv rau cov neeg mob uas muaj kab qhia ntawm lub hauv pliaj thiab ib ncig ntawm lub qhov muag. Lawv tuaj yeem tshwm sim txawm nyob rau hauv cov tub ntxhais hluas heev thiab muaj feem xyuam nrog kev coj cwj pwm ntawm lub ntsej muag. Yog hais tias cov wrinkles tob heev, tej zaum yuav tsum tau ib tug ntxiv txheej txheem - sau lawv nrog hyaluronic acid (piv txwv li, Dethail, Juvederm). tuaj yeem ua ke nrog lwm txoj hauv kev ua kom lub ntsej muag.
Cov tshuaj yog siv hauv kev tshem tawm:
- wrinkles nruab nrab ntawm pob muag (thaj chaw hauv pliaj);
- ncig lub qhov muag (crow's feet);
- lwm yam: daim tawv muag qis, thaj tsam ib ncig ntawm lub qhov ncauj, ntawm lub puab tsaig, caj dab.
Nyob rau hauv dermatology, nws kuj yog siv los kho hyperhidrosis ntawm ob txhais tes, ko taw thiab armpits. Kev txhaj tshuaj yog pom zoo nyob rau hauv kev kho mob ntawm cov kab mob txuam nrog rau cov leeg nqaij cramps thiab nervous tics, nyob rau hauv kev kho mob ntawm spasticity nyob rau hauv cov me nyuam nrog cerebral palsy, nyob rau hauv ophthalmology rau kev kho mob ntawm strabismus. Kev txhaj tshuaj Botox rau hauv qhov chaw tsim nyog ntawm lub hauv pliaj thiab caj dab kho mob taub hau.
txheej txheem nce qib
Botulinum toxin yog txhaj rau hauv cov leeg uas siv cov koob txhaj tshuaj pov tseg nrog rab koob tshwj xeeb. Ib qho me me ntawm cov tshuaj yog raug txhaj rau ntau qhov chaw ntawm lub ntsej muag. Cov txheej txheem tsis siv sijhawm ntev. Nyob ntawm tus naj npawb ntawm cov ntsiab lus txhaj tshuaj, nws yuav siv li 15-20 feeb. Mob txuam nrog kev ntxig yog tsawg heev. Ntau tus neeg mob muab piv rau tus ntsaum los yog yoov tshaj cum tom. Cov txheej txheem tsis xav tau tshuaj loog hauv zos. Rau kev nplij siab ntawm tus neeg mob, tshuaj loog hauv zos nrog cov tshuaj nplaum (xws li, EMLA) qee zaum siv li 1 teev ua ntej txheej txheem.
After surgery
Wrinkles yog tag nrho lossis ib nrab tshem tawm, lub ntsej muag qhia ua softer, zoo li ntuj, lub ntsej muag dav dav tau khaws cia. Cov koob tshuaj uas siv rau kev kho kom zoo nkauj yog ntau zaus qis dua li cov tshuaj kho mob thiab muaj kev nyab xeeb tag nrho. Xaiv tus kheej raws li koj xav tau.
Toxin pib ua hauv 2-3 hnub txij li lub sijhawm txhaj tshuaj. Ib tug puvCov nyhuv kho yuav pom tau tsuas yog tom qab 7-10 hnub. Cov nyhuv tom qab qhov txheej txheem yuav kav ntev li ntawm 6 lub hlis. Nws nyob ntawm tus yam ntxwv ntawm lub cev.
Tom qab lub sijhawm, lub ntsej muag maj mam ua tib yam. Tom qab tag nrho tas sij hawm ntawm kev txhaj tshuaj, kev kho mob yuav tsum tau rov ua dua. Lub ntsej muag twb tom qab ib txoj kev - uas yog, kwv yees li rau lub hlis ntawm kev txhaj tshuaj - zoo li hluas dua, so ntau dua.
Kev kho mob siv botulinum toxin rau lub hom phiaj zoo nkauj yog qhov yooj yim, nqa tawm ntawm tus neeg mob sab nraud, tsis tas yuav muaj kev kuaj mob tshwj xeeb. Tam sim ntawd tom qab ua tiav, tus neeg mob tuaj yeem rov qab mus rau lawv cov haujlwm txhua hnub.
YContraindications
Absolute:
- mob ntawm cov kab mob neuromuscular;
- hypersensitivity rau cov khoom ntawm cov tshuaj (tib neeg albumin);
- daim tawv nqaij mob;
- siv lwm yam tshuaj: aminoglycosides (streptomycin, gentamicin), aminoquinolines (chloroquine, hydroxychloroquine), D-penicillamine, Cyclosporine, Tubocurarine, lincomycin, tetracycline, polymyxins.
Tus txheeb ze:
- ntshav txhaws ntshav;
- siv cov tshuaj tiv thaiv coagulants (xws li tshuaj aspirin).
Kev kho mob tsis siv rau cov menyuam yaus hnub nyoog qis dua 12 xyoos (tshwj tsis yog qee qhov kev qhia txog paj hlwb thiab ophthalmic).
Tsis qhia txog kev phaisNws kuj yog ib tug contraindication, uas yuav tsum tau nco ntsoov. Tsis yog txhua tus neeg yuav tsum tau siv cov txheej txheem kom zoo nkauj nrog cov tshuaj no kom txo qis, thiab txoj haujlwm ntawm tus kws kho mob muaj peev xwm yog los piav qhia qhov tseeb rau tus neeg mob.
Side effects
Lub sijhawm thiab tom qab tus txheej txheem yuav tshwm sim:
- mob thaum lub sijhawm txhaj tshuaj;
- me me hematomas ntawm qhov chaw txhaj tshuaj yog tias rab koob nkag mus rau hauv lub nkoj;
- hloov qis qis ntawm cov plaub muag lossis nqa nws ntau dhau;
- me me o nrog me ntsis tingling ntawm qhov chaw txhaj tshuaj;
- cov nqaij ntshiv ntau dhau (thaum txo qis ntawm daim tawv muag, cov ces kaum ntawm lub qhov ncauj);
- mob taub hau tom qab noj tshuaj mob.
Note: Cov tshuaj tiv thaiv no feem ntau ploj tom qab ob peb hnub. Tsis muaj kev pheej hmoo ntawm kev caws pliav lossis kev puas tsuaj, thiab qhov chaw txhaj tshuaj tseem tsis pom. Qhov kev pheej hmoo ntawm cov kev mob tshwm sim nyob ntawm cov leeg nqaij uas cov tshuaj txhaj, yog li cov txheej txheem yuav tsum tau tham nrog tus kws kho mob ua ntej ua nws.
Kev coj cwj pwm tom qab kev phais
Tom qab txhaj tshuaj botulinum toxin:
- koj tsis tuaj yeem cob qhia lub ntsej muag nqaij ib teev;
- tsis txhob zaws ntawm qhov chaw txhaj tshuaj rau 4 teev;
- tom qab ua tiav, tsis txhob qaij koj lub taub hau (piv txwv li, thaum hnav khau lossis thaum pw tsaug zog).
Repeat txheej txheem
Kev txhaj tshuaj tuaj yeem rov ua dua txhua 6-8 lub hlis, tab sis tsis pub ntau tshaj ib zaug txhua 3 lub hlis. Qhov no yog ib qho ntawm cov txheej txheem uas cov neeg mobrov qab los nrog kev xyiv fab, vim nws muab qhov tshwm sim sai heev thiab mus sij hawm ntev, pom rau txhua tus. Tib lub sijhawm, cov txheej txheem no tsis cuam tshuam thiab ua tau yooj yim.
