發(fā)布時間：2018-04-28 19:16

  本文選題：吉蘭-巴雷綜合征 + 創(chuàng)傷��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：分析、討論創(chuàng)傷相關(guān)性吉蘭-巴雷綜合征的臨床特點 方法：搜集2011年10月—2014年3月就診于吉林大學(xué)白求恩第二醫(yī)院的診斷為吉蘭-巴雷綜合征的病例，進行重新的歸納、分析，選出3例病例資料完整的與創(chuàng)傷相關(guān)的病例。結(jié)合查閱相關(guān)中外文獻資料，復(fù)習(xí)創(chuàng)傷相關(guān)性吉蘭-巴雷綜合征的臨床特點，對這3份詳盡的病例進行評估、分析，探討本病的發(fā)病機制、診斷、鑒別診斷、治療及預(yù)后，加深對本病的認識。并對相關(guān)文獻加以回顧和復(fù)習(xí)。 結(jié)果：經(jīng)過閱讀、整理40份吉蘭-巴雷綜合征病例，其中急性運動軸索型神經(jīng)病(AMAN)3例，經(jīng)典型吉蘭-巴雷綜合征（AIDP）32例、復(fù)發(fā)型吉蘭-巴雷綜合征（R-GBS）3例，，Miller-Fisher綜合征（MFS）2例。篩選出病例資料較完整的與創(chuàng)傷相關(guān)的吉蘭-巴雷綜合征病例3份。這3份病例均屬于罕見型GBS，平均發(fā)病年齡為52.6歲，其中2例發(fā)生在術(shù)后，1例發(fā)生在外傷后，3份病例均以肢體運動障礙為首發(fā)癥狀，其中病例1與病例2合并顱神經(jīng)受累，病例2與病例3呼吸肌受累。3份病例中，病例1應(yīng)用激素治療，病例2應(yīng)用激素聯(lián)合丙種球蛋白治療，病例3僅給予支持治療。病例1預(yù)后尚可；病例2半年后隨訪仍臥床，需簡易呼吸機輔助呼吸；病例3死亡。 結(jié)論：1、以創(chuàng)傷為誘因的吉蘭-巴雷綜合征較罕見，多見于氣管插管身麻醉下的手術(shù)后發(fā)生。2、創(chuàng)傷后后誘發(fā)的吉蘭-巴雷綜合征預(yù)后差，病情重。3、患者創(chuàng)傷后或手術(shù)后的一些并發(fā)癥掩蓋了患者的一些體征、使患者病情變得錯綜復(fù)雜，不能及時診斷、甚至發(fā)生延誤。4、重視創(chuàng)傷后或手術(shù)后新發(fā)肢體無力癥狀，認識創(chuàng)傷相關(guān)性GBS，及時診治。
[Abstract]:Objective: to analyze and discuss the clinical features of traumatic associated Guillain-Barre syndrome. Methods: from October 2011 to March 2014, the cases diagnosed as Guillain-Barre syndrome in the second Hospital of Bai Qiuen of Jilin University were collected and analyzed, and 3 cases of trauma related cases with complete data were selected. To review the clinical characteristics of traumatic related Guillain-Barre syndrome, to evaluate and analyze the three cases, and to discuss the pathogenesis, diagnosis, differential diagnosis, treatment and prognosis of the disease. Deepen our understanding of the disease. The related literature is reviewed and reviewed. Results: after reading, 40 cases of Guillain-Barre syndrome were collected, including 3 cases of acute motor axonal neuropathy, 32 cases of classic Guillain-Barre syndrome and 3 cases of recurrent Guillain-Barre syndrome. Three cases of Guillain-Barre syndrome related to trauma were selected. The average age of the three cases was 52.6 years old. Among them, 2 cases occurred in 1 case after operation and 1 case occurred after trauma. All the 3 cases were characterized by limb motor disorder, among which case 1 and case 2 were complicated with cranial nerve involvement. Cases 2 and 3 had respiratory muscle involvement, case 1 was treated with hormone, case 2 was treated with hormone combined with gamma globulin, case 3 was treated only with support therapy. Case 1 had a good prognosis; case 2 was still in bed after half a year follow-up and needed simple ventilator to assist breathing; case 3 died. ConclusionGuillain-Barre syndrome, which is induced by trauma, is rare. It is more commonly seen after operation under tracheal intubation and anesthesia. The prognosis of Guillain-Barre syndrome induced by trauma is poor. The patient's condition is serious. 3. Some complications after trauma or surgery cover up some signs of the patient, which make the patient's condition complicated and unable to be diagnosed in time, and even delay .4. pay attention to the symptoms of post-traumatic or post-operative newly developed limb weakness. To understand the correlation of trauma GBS, timely diagnosis and treatment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R745.43

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本文編號：1816530