摘要
2010年11月至2018年2月中南大学湘雅医院收治11例儿童变异型吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)患者,主要临床表现为颅神经受累(9例)、肢体无力(9例)、共济失调(8例)、感觉异常(7例),均有腱反射减弱或消失;脑脊液呈现蛋白-细胞分离现象6例,肌电图提示神经源性改变8例。5例患者予丙种球蛋白治疗,1例予大剂量激素治疗,1例予丙种球蛋白联合大剂量激素治疗,4例对症治疗。所有患者预后良好,未遗留明显神经系统后遗症。变异型GBS的诊断主要基于临床表现。有颅神经受累表现、共济失调及腱反射减弱或消失的患者,需高度警惕变异型GBS。脑脊液蛋白-细胞分离现象及肌电图检查有助于明确诊断。变异型GBS属于自限性疾病,重症患者免疫治疗可缓解病情。
From November,2010 to February,2018,11 children with variants of Guillain-Barrésyndrome(GBS)were treated in Xiangya Hospital of Central South University.Clinical manifestations included cranial nerve involvement in 9 cases,limb weakness in 9 cases,ataxia in 8 cases,abnormal sensation in 7 cases,weakened or disappeared tendon reflex in all cases,albuminocytologic dissociation of cerebrospinal fluid in 6 cases,and neurogenic changes in electromyography in 8 cases.Immune globulin and steroids were given to 5 cases and 1 case,respectively,while the combination of immune globulin with steroids was given to 1 case,and symptomatic treatment was given to 4 cases.All treatments were effective,remaining no apparent side effect for nervous system.The diagnosis of GBS variants was based on clinical manifestation.Patients who had cranial nerve involvement,ataxia and weakened or disappeared tendon reflex should be paid attention.Albuminocytologic dissociation of cerebrospinal fluid and electromyography were helpful to diagnosis.GBS variants were self-limited disease.Immunotherapy can ease the patients’critical condition.
作者
黎巧
王国丽
何芳
杨海燕
吴丽文
LI Qiao;WANG Guoli;HE Fang;YANG Haiyan;WU Liwen(Department of Pediatrics,Xiangya Hospital,Central South University Changsha 410008,China)
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2019年第11期1311-1315,共5页
Journal of Central South University ：Medical Science
基金
国家自然科学基金(81671297)~~
