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埃及消除脊髓灰质炎后期,吉兰-巴雷综合征成为儿童急性弛缓性麻痹的主要病因。

Guillain-Barré syndrome as a prominent cause of childhood acute flaccid paralysis in post polio eradication era in Egypt.

机构信息

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.

出版信息

Eur J Paediatr Neurol. 2011 May;15(3):241-6. doi: 10.1016/j.ejpn.2010.11.008. Epub 2010 Dec 18.

Abstract

Guillain-Barré syndrome often follows an antecedent gastrointestinal or respiratory illness but, in rare cases, follows vaccination. This study was conducted to identify preceding events, demographic, clinical characteristics and prognostic factors of childhood Guillain-Barré syndrome after post-poliomyelitis eradication era in Egypt. This is a prospective study of all children with GBS (no = 50) admitted to pediatric Cairo University Hospital between January 2006 and June 2007 (70.42% of all acute flaccid paralysis patients during this period). Upper respiratory infection was the most common preceding event (24%) while only 4 patients (8%) reported antecedent oral polio vaccine. Motor deficit was frequent and severe (quadriparesis in 92% and paraparesis in 8%). Autonomic dysfunction was recorded in 32% of patients. Forty two percent of patients had poor outcome with 16% deaths. Presence of severe disability on admission and on nadir, cranial nerve affection or the need for mechanical ventilator were found to be significant predictors for poor outcome.

摘要

格林-巴利综合征常继发于胃肠道或呼吸道感染,但在少数情况下,也可继发于疫苗接种。本研究旨在确定埃及脊髓灰质炎后时期儿童格林-巴利综合征发病前的事件、人口统计学、临床特征和预后因素。这是一项前瞻性研究,纳入了 2006 年 1 月至 2007 年 6 月期间入住开罗大学医院儿科病房的所有格林-巴利综合征患儿(占同期急性弛缓性麻痹患儿的 70.42%)。上呼吸道感染是最常见的前驱事件(24%),仅有 4 例(8%)患儿报告有口服脊髓灰质炎疫苗接种史。运动障碍频繁且严重(四肢瘫痪 92%,截瘫 8%)。32%的患儿出现自主神经功能障碍。42%的患儿预后不良,死亡率为 16%。入院时和最低点时严重残疾、颅神经受累或需要机械通气是预后不良的显著预测因素。

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