儿童吉兰-巴雷综合征需要辅助呼吸的危险因素分析  

Risk factors associated with the need for mechanical ventilation in children with Guillain-Barrésyndrome

作　　者：李承 孙瑞迪[1] 冯丽 江军[1] LI Cheng;SUN Rui-Di;FENG Li;JIANG Jun(Department of Electrophysiology,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]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,湖北武汉430016

出　　处：《中国当代儿科杂志》2021年第9期922-926,共5页Chinese Journal of Contemporary Pediatrics

基　　金：武汉儿童医院院内科研项目资助(2021FE015)。

摘　　要：目的研究儿童吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)需要辅助呼吸的危险因素。方法回顾性收集107例GBS患儿的临床资料。根据是否需要辅助呼吸,分为需要辅助呼吸组(n=16)和不需要辅助呼吸组(n=91)。比较两组患儿的临床资料,采用多因素logistic回归分析法分析GBS患儿需要辅助呼吸的危险因素。结果107例GBS患儿中,16例患儿需要辅助呼吸,发生率为15.0%。需要辅助呼吸组面肌和/或延髓肌无力比例高于不需要辅助呼吸组,起病到病情高峰期天数短于不需要辅助呼吸组,首次就诊休斯功能分级量表得分高于不需要辅助呼吸组(均P<0.05)。面肌和/或延髓肌无力、起病到病情高峰期天数短是GBS患儿需要辅助呼吸的危险因素(分别OR=5.053、1.239,P<0.05)。结论面肌和/或延髓肌无力和起病到病情高峰期天数的缩短可能增加GBS需要辅助呼吸的风险。Objective To study the risk factors associated with the need for mechanical ventilation in children with Guillain-Barrésyndrome(GBS).Methods The medical data of 107 children with GBS were retrospectively reviewed.According to whether mechanical ventilation was required,the children were divided into a mechanical ventilation group with 16 children and a non-mechanical ventilation group with 91 children.The risk factors associated with the need for mechanical ventilation in children with GBS were identified by a multivariate logistic regression analysis.Results Among the 107 children,16(15.0%)required mechanical ventilation.Compared with the non-mechanical ventilation group,the mechanical ventilation group had a significantly higher proportion of children with facial and/or bulbar muscle weakness,a significantly shorter duration from the onset to the peak of the disease,and a significantly higher Hughes Functional Grading Scale score at the first visit(P<0.05).Facial and/or bulbar muscle weakness and short duration from the onset to the peak of the disease were risk factors associated with the need for mechanical ventilation in children with GBS(OR=5.053 and 1.239 respectively,P<0.05).Conclusions Facial and/or bulbar muscle weakness and short duration from the onset to the peak of the disease may increase the risk of mechanical ventilation in children with GBS.

关 键 词：吉兰-巴雷综合征 辅助呼吸 儿童 

分 类 号：R745.43[医药卫生—神经病学与精神病学]