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成功治疗一名因呼吸肌麻痹需行气管切开术的12岁格林-巴利综合征男孩:病例报告。

Successful treatment of a 12-year-old boy with Guillain-Barré syndrome requiring tracheostomy due to respiratory muscle paralysis: A case report.

作者信息

Miyamoto Manabu, Imataka George, Ichikawa Go, Saito Yutaka, Kashiwagi Takashi, Kaji Yoshiyuki, Wake Koji, Funakoshi Kei, Nagashima Takahide, Kokubun Norito, Yoshihara Shigemi

机构信息

Department of Pediatrics, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan.

Department of Emergency and Critical Care Medicine, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan.

出版信息

Exp Ther Med. 2020 Feb;19(2):1091-1094. doi: 10.3892/etm.2019.8311. Epub 2019 Dec 10.

Abstract

Childhood Guillain-Barré syndrome (GBS) occasionally leads to respiratory failure early after onset, requiring long-term ventilation management after tracheal intubation. However, patients requiring tracheostomy management are rare. In the present study, a case of a 12-year-old boy with GBS who required artificial respiration management due to rapid progression of respiratory muscle paralysis is reported. Intravenous immunoglobulin (IVIg) and pulse steroid therapy were provided; however, both were ineffective and tracheostomy was necessary 26 days after onset. A second course of IVIg and pulse steroid therapy was administered on day 34. With continued rehabilitation, the patient was able to walk long distances on day 74 and was subsequently discharged on day 89. In cases of severe GBS, when IVIg and pulse steroid therapy do not improve the respiratory muscle strength of the patient, early tracheostomy may improve the patient's quality of life during artificial respiration management.

摘要

儿童吉兰-巴雷综合征(GBS)在发病后早期偶尔会导致呼吸衰竭,气管插管后需要长期通气管理。然而,需要气管切开术管理的患者很少见。在本研究中,报告了一例12岁患有GBS的男孩,因其呼吸肌麻痹迅速进展而需要人工呼吸管理。给予了静脉注射免疫球蛋白(IVIg)和脉冲类固醇治疗;然而,两者均无效,发病26天后进行了气管切开术。在第34天给予了第二个疗程的IVIg和脉冲类固醇治疗。随着持续康复,患者在第74天能够长距离行走,随后在第89天出院。在严重GBS病例中,当IVIg和脉冲类固醇治疗不能改善患者的呼吸肌力量时,早期气管切开术可能会改善人工呼吸管理期间患者的生活质量。

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本文引用的文献

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Guillain-Barré syndrome.吉兰-巴雷综合征
N Engl J Med. 2012 Jun 14;366(24):2294-304. doi: 10.1056/NEJMra1114525.

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