Karlsen B, Vedeler C A
Seksjon for klinisk nevrofysiologi, Haukeland Sykehus 5021 Bergen.
Tidsskr Nor Laegeforen. 2001 Mar 10;121(7):799-801.
Neuromuscular complications are common in patients treated for sepsis and multiple organ dysfunction in critical care units. Failure to wean from the ventilator, due to involvement of the respiratory system, and severe muscular weakness are typical symptoms. Electrophysiological examination demonstrates fibrillation potentials and reduction of compound muscular action potential amplitudes.
We report three patients with severe muscular weakness during treatment of critical illness.
Critical illness polyneuropathy was the main cause of weakness in two patients, with a presumed superimposed myopathy in one. A third patient had critical illness myopathy.
Critical illness polyneuropathy and myopathy--either as separate or combined entities--are common causes of muscular weakness during treatment of critical illness. These disorders are often difficult to distinguish from each other, as the clinical and electrophysiological findings may overlap. Sepsis and multiple organ dysfunction are the main aetiological factors, but certain drugs may contribute in the pathogenesis. No specific treatment exists. In the most severe cases long-lasting physiotherapy and rehabilitation is needed.
在重症监护病房接受脓毒症和多器官功能障碍治疗的患者中，神经肌肉并发症很常见。由于呼吸系统受累导致无法脱机以及严重肌无力是典型症状。电生理检查显示有纤颤电位和复合肌肉动作电位幅度降低。
我们报告了3例危重症治疗期间出现严重肌无力的患者。
在2例患者中，危重症多发性神经病是肌无力的主要原因，1例推测合并有肌病。第3例患者患有危重症肌病。
危重症多发性神经病和肌病——无论是单独还是合并存在——都是危重症治疗期间肌无力的常见原因。这些疾病往往难以相互区分，因为临床和电生理表现可能重叠。脓毒症和多器官功能障碍是主要病因，但某些药物可能在发病机制中起作用。目前尚无特异性治疗方法。在最严重的情况下，需要长期的物理治疗和康复治疗。
