Kassam Adam, Phadke Chetan P, Ismail Farooq, Boulias Chris
1Spasticity Research Program,West Park Healthcare Centre,Toronto, ON,Canada.
Can J Neurol Sci. 2016 Jul;43(4):581-3. doi: 10.1017/cjn.2015.397. Epub 2016 Mar 4.
To understand physician preferences and bleeding complication rates of intramuscular botulinum neurotoxin type A injections for spasticity management in anticoagulated patients, questionnaires were mailed to 138 physicians across Canada. The international normalized ratio comfort range for injections was <2.0 in 10%, 2.0 to 2.5 in 35%, 2.6 to 3.0 in 25%, and 3.1 to 3.5 in 20% of physicians. Only 23% injected outside their comfort value and 57% did not; 72% did not normalize the international normalized ratio value before injections. Only one injector reported the development of compartment syndrome. As expected, high variability exists in physician preferences in botulinum neurotoxin type A injection in anticoagulated patients.
为了解加拿大各地138名医生对于在接受抗凝治疗的患者中使用A型肉毒杆菌神经毒素进行肌内注射治疗痉挛的偏好以及出血并发症发生率，研究人员向他们邮寄了调查问卷。对于注射时国际标准化比值（INR）的适宜范围，10%的医生认为是<2.0，35%的医生认为是2.0至2.5，25%的医生认为是2.6至3.0，20%的医生认为是3.1至3.5。只有23%的医生在其认为的适宜值范围之外进行注射，57%的医生则没有；72%的医生在注射前未使国际标准化比值恢复正常。只有一名注射者报告出现了骨筋膜室综合征。正如预期的那样，在接受抗凝治疗的患者中，医生对于A型肉毒杆菌神经毒素注射的偏好存在很大差异。
