摘要
目的分析格林巴利综合征的临床特点及其急诊处理时误诊误治原因。方法按《中华神经精神杂志》黄山会议诊断标准,对1994年1月1日至2004年12月31日在我院住院的145例格林巴利综合征患者进行诊断和临床类型分型,探讨其临床症状和辅助检查特点,并进一步分析其急诊处理时误诊误治的原因。结果145例格林巴利综合征患者以青壮年为主,男女比例为2.5∶1;其中轻型34.5%,中型25.5%,重型13.9%,极重型7.6%,再发型4.1%,慢性型12.4%,变异型2.1%。首发症状多样,常见为双侧肢体乏力和/或麻木,部分表现为一侧肢体发病再发展到对侧,也可非特异性地表现为头痛、眼痛、口角歪斜、视物模糊、咀嚼无力等,急诊处理时误诊误治23例,占15.9%。71.3%患者出现脑脊液蛋白细胞分离,蛋白含量改变与病程相关而与病情无关,46.7%患者在发病超早期(≤7d)即可出现蛋白增高。结论格林巴利综合征是临床上急性弛缓性瘫痪的常见病,轻型预后良好,但极重型病死率极高,且在发病早期由于首发症状多样性易在急诊处理时误诊误治。
Objective To study the clinical characteristics of Guillain-Barré syndrome （GBS） and the misdiagnosis and mismanagement in emergency department. Methods According to the diagnosis criteria of Chinese Journal of Neurology and Psychology, 145 GBS in-hospital patients in our hospital from January 1, 1994 to December 31,2004 were studied to ilnd characteristics of GBS and auxiliary examinations. The reasons for GBS misdiagnosis and mismanagement were analysis. Results Most of the patients were young, the ratio of male to female was 2.5 to 1. Among them, mildtype was 34.5% , medium-type was 25.5%, severe-type was 13.9% , very severe-type was 7.6% , relapse-type was 4.1%, chronic-type was 12.4% and variation-type was 2.1%. The initial symptoms were multiplie. Bilateral limbs weakness and/or numbess were the most common symptom, and non-specificity asymmetrical weakness and/or numbess, headache, ophthalmalgia, distortion of angle of mouth or weak mastication were uncommon symptoms. Twenty-three patients （ 15.9 % ） were misdiagnosed in emergency department. 71.3 % patients developed albuminocytolgoic dissociation in cerebrospinal fluid. The content of protein in cerebrospinal fluid was correlated to the course of disease and uncorrelated to the patitent＇s condition. Conclusion GBS was a common cause of clinical acute flaccid paralysis, the mild-type has good prognosis and the mortality of very serere-type is high. GBS should be paid attention to in emergency department.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第4期354-357,共4页
Chinese Journal of Emergency Medicine
关键词
格林-巴利综合征
误诊
误治
急诊
Guillain-Barré syndrome
Misdiagnosis
Mismanagement
Emergency
