儿童吉兰-巴雷综合征诊断延误的影响因素及其对预后的影响

发布时间：2018-03-30 19:29

本文选题：吉兰-巴雷综合征　切入点：诊断　出处：《临床儿科杂志》2017年11期

【摘要】：目的探讨儿童吉兰-巴雷综合征(GBS)诊断延误的影响因素及其对预后的影响。方法回顾分析118例GBS患儿的临床资料,包括经典型GBS 100例及变异型GBS 18例[变异型中Miller-Fisher综合征(MFS)13例,头颈肩型吉兰-巴雷综合征(PCB)5例]。将患儿分为首诊诊断为GBS组及首诊未诊断为GBS组,并对两组进行对比。结果在118例GBS患儿中,首诊诊断为GBS组76例,首诊未诊断为GBS组42例。与首诊未诊断为GBS组相比,首诊诊断为GBS组患儿肌肉力弱及典型肌肉力弱的比例较高,而肢体疼痛和呼吸功能受损的比例较低,初次就诊进行神经系统检查的比例较高,短期预后较好,发病至开始治疗时间较短,差异均有统计学意义(P0.05)。与经典型GBS组相比,变异型GBS组患儿行走不稳、颅神经受累的比例较高,而首诊诊断为GBS比例较低,从发病到开始治疗的时间较长,差异均有统计学意义(P0.05)。结论儿童GBS诊断延误与临床症状不典型及初次就诊未进行神经系统检查有关,诊断延误会影响患儿的短期预后。
[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.
【作者单位】：华中科技大学同济医学院附属武汉儿童医院神经电生理室;华中科技大学同济医学院附属武汉儿童医院神经内科;
【基金】：武汉市科技创新平台-儿童神经疾病临床医学研究中心资助项目(No.武科2014-160)
【分类号】：R745.43

【相似文献】