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肺移植术后早期的吉兰-巴雷综合征:病例报告

Guillain-Barré Syndrome after Lung Transplantation in the Immediate Postoperative Period: Case Report.

作者信息

Gu Byung Mo, Ko Ho Hyun, Lee Hong Kyu, Ra Yong Joon, Lee Hee Sung, Kim Hyoung Soo

机构信息

Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.

Department of Thoracic and Cardiovascular Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

出版信息

J Chest Surg. 2021 Oct 5;54(5):396-399. doi: 10.5090/jcs.20.074.

Abstract

A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventilation, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid administration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while communication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous immunoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

摘要

一名58岁男性,机械通气无法维持氧饱和度,因静脉-静脉体外膜肺氧合(ECMO)治疗入住我院。他被诊断为甲型流感肺炎所致的急性呼吸窘迫综合征(ARDS)。使用抗生素和类固醇治疗后病情稳定,但由于感染后肺部后遗症,ECMO撤机失败。入院第84天,他接受了双侧肺移植。术后,即使停用镇静剂3天后他仍未恢复意识。然而,保留了自发瞳孔反射和眼球运动,而沟通及上下肢运动受到影响。神经传导研究诊断为吉兰-巴雷综合征。给予静脉注射免疫球蛋白和血浆置换治疗。面部肌肉有轻度恢复,但术后24天因进行性ARDS和脓毒症死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e66/8548184/36fdad9ca19f/jcs-54-5-396-f1.jpg

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