ICU获得性肌无力的发生和诊断及治疗  

Occurrence,diagnosis,and rehabilitation of intensive care unit-acquired weakness

作　　者：王晓敏 朱晓萍[1] Wang Xiaomin;Zhu Xiaoping(Department of Respiratory,East Hospital,Tong ji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院呼吸内科,上海200120

出　　处：《中华危重病急救医学》2020年第8期1020-1024,共5页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81970089)。

摘　　要：近年来,人们逐渐认识到肌无力是重症监护病房(ICU)的突出和常见问题,预计全球每年有100多万患者发生ICU获得性肌无力(ICU-AW).ICU-AW的病因复杂,预后不良,严重者甚至出现呼吸肌瘫痪,造成机械通气时间和住院时间延长,增加ICU患者住院病死率,并导致慢性残疾.目前ICU-AW的发病机制尚未完全清楚,早期识别和诊断困难,且缺乏标准的治疗策略.本文围绕肌肉萎缩和肌肉功能障碍的发病机制进行综述,分析目前ICU-AW诊断方法的优缺点,并在此基础上探讨康复治疗对ICU-AW患者神经肌肉功能恢复的重要意义,以期提高临床医师对ICU-AW患者的诊治水平,降低病死率,改善预后.In recent years,it has been gradually recognized that muscle weakness is a prominent and common problem in intensive care unit(ICU).It is estimated that more than 1 million patients worldwide develop ICU-acquired weakness(ICU-AW)each year.Its etiology is complex and the prognosis is poor.Respiratory muscle paralysis may even occur in severe cases,resulting in prolonged mechanical ventilation and hospitalization,increasing the hospital mortality of ICU patients,and leading to chronic disability.The pathogenesis of ICU-AW is not yet fully understood.Early recognition and diagnosis are difficult,and standard treatment strategies are lacking.This review focuses on the pathogenesis of muscle atrophy and muscle dysfunction,analyzes the advantages and disadvantages of current diagnostic methods for ICU-AW,and discusses the important significance of rehabilitation for the recovery of neuromuscular function in patients with ICU-AW on this basis,in order to improve clinicians'diagnosis and treatment of patients with ICU-AW,reduce mortality and improve prognosis.

关 键 词：ICU获得性肌无力 发病机制 诊断 康复治疗 

分 类 号：R746.1[医药卫生—神经病学与精神病学]