手术相关性Guillain-Barre综合征临床资料分析  

Analysis of Clinical Data of Patients with Surgery-related Guillain-Barre Syndrome Related to Surgery

作　　者：陈晓莉[1] 董睿[2] 陈瑞利[1] 杨谦[1] 雷琦[1] CHEN Xiao-li;DONG Rui;CHEN Rui-li;YANG Qian;LEI Qi(The Second Department of Neurology,Shaanxi Provincial People's Hospital,Xi'an 710068,China;Department of Information Centre,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院神经内二科,西安710068 [2]陕西省人民医院数据中心,西安710068

出　　处：《临床误诊误治》2021年第4期93-97,共5页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省社会发展科技攻关项目(2017SF-289)。

摘　　要：目的总结中国大陆地区手术相关性Guillain-Barre综合征(GBS)患者的临床特点。方法计算机检索中文生物医学数据库、万方数据库、维普数据库及中国知网数据库,检索年限为1990年1月—2020年5月,对中国大陆地区已发表的,以及我院确诊的手术相关性GBS病的例临床资料进行总结分析。结果共检索到62篇文献,筛选出45例,加上我院4例,共计49例确诊病例,均符合纳入标准。手术相关性GBS发病以中年人为主,男性多于女性,多有骨科脊柱和颅脑手术的诱因,发病时间为(9.94±7.27)d,大部分病例仍符合GBS双侧对称性的特点,周围神经轴索损伤比例较高,占68.00%,神经节苷脂抗体阳性患者在检查者中占72.73%,重型病例高达81.63%,经有效治疗后仍有40.82%患者预后不佳。结论手术相关性GBS临床表现多样,病情较重,预后较差,及早明确诊断、早治疗有助于促进病情好转,减轻致残、致死率。Objective To summarize clinical characteristics of patients with surgery-related Guillain-Barre syndrome(GBS)in China's Mainland.Methods CBMdisc,Wanfang,VIP and CNKI databases during January 1990 and May 2020 were searched,and clinical data for the published articles of surgery-related GBS in China's Mainland and the surgery-related GBS patients who had confirmed in our hospital were summarized and analyzed.Results Sixty-two articles(a total of 45 patients)were retrieved,and a total of 49 patients(including 4 patients in our hospital)met the inclusion criteria.Surgery-related GBS mainly attacked in middle-aged people,and there were more men than women.Most of them had orthopedic spinal and cranial surgery,and the onset time was(9.94±7.27)d.Most cases still conformed to characteristics of GBS bilateral symmetry with higher ratio of peripheral nerve axonal damage which accounted for 68.00%.The ratio of ganglioside antibody positive patients accounted for 72.73%,and the ratio of severe cases were up to 81.63%.After effective treatment,40.82%of patients also had poor prognoses.Conclusion Surgery-related GBS has diverse clinical manifestations with severe pathogenetic conditions and poor prognosis,and therefore early diagnosis and treatment may help improve pathogenetic conditions and reduce disability and mortality rate.

关 键 词：GUILLAIN-BARRE综合征 外科手术 手术后并发症 肌电图 脑脊液 预后 

分 类 号：R745.44[医药卫生—神经病学与精神病学]