创伤相关性吉兰—巴雷综合征的临床病例分析并文献复习

发布时间：2018-04-28 19:16

本文选题：吉兰-巴雷综合征 + 创伤　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：分析、讨论创伤相关性吉兰-巴雷综合征的临床特点方法：搜集2011年10月—2014年3月就诊于吉林大学白求恩第二医院的诊断为吉兰-巴雷综合征的病例，进行重新的归纳、分析，选出3例病例资料完整的与创伤相关的病例。结合查阅相关中外文献资料，复习创伤相关性吉兰-巴雷综合征的临床特点，对这3份详尽的病例进行评估、分析，探讨本病的发病机制、诊断、鉴别诊断、治疗及预后，加深对本病的认识。并对相关文献加以回顾和复习。结果：经过阅读、整理40份吉兰-巴雷综合征病例，其中急性运动轴索型神经病(AMAN)3例，经典型吉兰-巴雷综合征（AIDP）32例、复发型吉兰-巴雷综合征（R-GBS）3例，，Miller-Fisher综合征（MFS）2例。筛选出病例资料较完整的与创伤相关的吉兰-巴雷综合征病例3份。这3份病例均属于罕见型GBS，平均发病年龄为52.6岁，其中2例发生在术后，1例发生在外伤后，3份病例均以肢体运动障碍为首发症状，其中病例1与病例2合并颅神经受累，病例2与病例3呼吸肌受累。3份病例中，病例1应用激素治疗，病例2应用激素联合丙种球蛋白治疗，病例3仅给予支持治疗。病例1预后尚可；病例2半年后随访仍卧床，需简易呼吸机辅助呼吸；病例3死亡。结论：1、以创伤为诱因的吉兰-巴雷综合征较罕见，多见于气管插管身麻醉下的手术后发生。2、创伤后后诱发的吉兰-巴雷综合征预后差，病情重。3、患者创伤后或手术后的一些并发症掩盖了患者的一些体征、使患者病情变得错综复杂，不能及时诊断、甚至发生延误。4、重视创伤后或手术后新发肢体无力症状，认识创伤相关性GBS，及时诊治。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R745.43

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