發(fā)布時間：2018-03-30 19:29

  本文選題：吉蘭-巴雷綜合征　切入點：診斷　出處：《臨床兒科雜志》2017年11期

【摘要】：目的探討兒童吉蘭-巴雷綜合征(GBS)診斷延誤的影響因素及其對預(yù)后的影響。方法回顧分析118例GBS患兒的臨床資料,包括經(jīng)典型GBS 100例及變異型GBS 18例[變異型中Miller-Fisher綜合征(MFS)13例,頭頸肩型吉蘭-巴雷綜合征(PCB)5例]。將患兒分為首診診斷為GBS組及首診未診斷為GBS組,并對兩組進行對比。結(jié)果在118例GBS患兒中,首診診斷為GBS組76例,首診未診斷為GBS組42例。與首診未診斷為GBS組相比,首診診斷為GBS組患兒肌肉力弱及典型肌肉力弱的比例較高,而肢體疼痛和呼吸功能受損的比例較低,初次就診進行神經(jīng)系統(tǒng)檢查的比例較高,短期預(yù)后較好,發(fā)病至開始治療時間較短,差異均有統(tǒng)計學(xué)意義(P0.05)。與經(jīng)典型GBS組相比,變異型GBS組患兒行走不穩(wěn)、顱神經(jīng)受累的比例較高,而首診診斷為GBS比例較低,從發(fā)病到開始治療的時間較長,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論兒童GBS診斷延誤與臨床癥狀不典型及初次就診未進行神經(jīng)系統(tǒng)檢查有關(guān),診斷延誤會影響患兒的短期預(yù)后。
[Abstract]:Objective to investigate the factors influencing the delayed diagnosis of Guillain-Barre syndrome (GBS) in children and its influence on prognosis. Methods Clinical data of 118 cases of GBS were retrospectively analyzed, including 100 cases of classical GBS and 18 cases of variant GBS. Five cases of head and neck type Guillain-Barre syndrome were divided into two groups: the first diagnosis group was GBS group and the first diagnosis group was GBS group, and the comparison was made between the two groups. Results among 118 cases of GBS, 76 cases were first diagnosed as GBS group. 42 cases of GBS were not diagnosed in the first diagnosis. Compared with the GBS group, the proportion of muscle weakness and typical muscle weakness in the first diagnosis of GBS group was higher, but the proportion of limb pain and respiratory dysfunction was lower. The rate of nervous system examination was higher, the short-term prognosis was better, the time from onset to treatment was shorter, the difference was statistically significant (P 0.05). Compared with classical GBS group, the children of variant GBS group walked unsteadily. The proportion of cranial nerve involvement was higher, while the first diagnosis of GBS was lower, and the time from onset to beginning of treatment was longer. Conclusion the delayed diagnosis of GBS in children is related to the atypical clinical symptoms and the absence of nervous system examination in the first visit, and the delayed diagnosis will affect the short-term prognosis of the children.
【作者單位】： 華中科技大學(xué)同濟醫(yī)學(xué)院附屬武漢兒童醫(yī)院神經(jīng)電生理室;華中科技大學(xué)同濟醫(yī)學(xué)院附屬武漢兒童醫(yī)院神經(jīng)內(nèi)科;
【基金】：武漢市科技創(chuàng)新平臺-兒童神經(jīng)疾病臨床醫(yī)學(xué)研究中心資助項目(No.武科2014-160)
【分類號】：R745.43

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