王虹富;张哲林;杨艳泽;

• 1:巴彦淖尔市医院
• 2:内蒙古医科大学附属医院

摘要(Abstract)：

目的 分析危重型吉兰-巴雷综合征患者的临床特点。方法 纳入2010-01—2020-12在内蒙古医科大学附属医院、巴彦淖尔市医院住院治疗且需有创通气的16例吉兰-巴雷综合征患者，对患者的年龄、性别、职业、前驱病史、首发症状、发病至高峰时间、脑神经受累情况、肌电图、实验室检查指标、治疗及预后进行回顾性分析。结果 青年（18～40岁）2例，中年（41～65岁）10例，老年（≥66岁）4例；男女比例为15∶1；农民8例，工人2例，自由职业4例，企业管理人员2例；发病前有明显诱因11例，无明显诱因5例；单纯以肢体无力、麻木为首发症状10例，肢体无力合并言语不清、进食水呛咳起病6例；16例患者腱反射减退或消失；发病至症状达到高峰时间（需要机械通气）时间波动在18 h～7 d;12例（75%）脑神经受损；完成肌电图例检查12例，8例轴索型，4例脱髓鞘型；脑脊液蛋白-细胞分离10例，5例未做，1例无蛋白-细胞分离。所有患者接受免疫球蛋白联合激素冲击治疗，10例出院时呼吸肌功能恢复，脱离呼吸机，日常活动能力丧失，2例死亡，4例放弃治疗；10例出院时呼吸肌功能恢复患者住院时间1～3个月。结论 吉兰-巴雷综合征患者大部分发病前存在呼吸道感染或腹泻史，急性危重型吉兰-巴雷综合征多见于中年男性体力劳动者，多存在脑神经损伤，特别是合并舌咽迷走神经损伤患者，肌电图以轴索损害为主。经过正规治疗，疗程>1个月的大部分患者可以脱离呼吸机。

关键词(KeyWords)： 吉兰-巴雷综合征;机械通气;临床特点;脑神经损伤;轴索损害;预后

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王虹富;张哲林;杨艳泽;

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