Sunderrajan E V, Davenport J
Medicine (Baltimore). 1985 Sep;64(5):333-41. doi: 10.1097/00005792-198509000-00005.
In a retrospective analysis of 40 hospitalized patients with the Guillain-Barré syndrome (GBS), we related the use and outcome of assisted ventilation to specific quantitative details of the neurologic illness. Two patients had an unusually prolonged course: they were ventilated for 374 and 396 days before successful weaning. The other 38 patients were similar in most respects to those in previously reported series. Sixteen ventilated patients were hospitalized 56.6 +/- 10.6 (mean +/- S.E.M.) days, were ventilated 27.9 +/- 6.5 days, and had primarily pulmonary complications. There were 4 deaths during ventilation, and 9 of 13 survivors (69%) had a short-term excellent functional neurologic outcome. Attention to the neurologic details of the course of illness may spare some patients from tracheostomy. Twenty-two patients not requiring respirator support suffered distinctly less severe neuromuscular impairment with minimal cranial neuropathy, had no occurrence of pneumonia, and were discharged after 19.1 +/- 4.6 days. Eighty-one percent had an excellent functional outcome. The wide range of manifestations and severity of patients with GBS requires the attending physician to be flexible in dealing with each case and not make management decisions arbitrarily, by reference to a hypothetical "typical case."
在一项对40例住院吉兰-巴雷综合征（GBS）患者的回顾性分析中，我们将辅助通气的使用情况及结果与神经系统疾病的具体定量细节相关联。两名患者病程异常延长：他们在成功脱机前分别接受了374天和396天的通气支持。其他38例患者在大多数方面与先前报道系列中的患者相似。16例接受通气的患者住院时间为56.6±10.6（均值±标准误）天，通气时间为27.9±6.5天，主要发生肺部并发症。通气期间有4例死亡，13名幸存者中有9例（69%）在短期内神经系统功能恢复良好。关注疾病过程中的神经学细节可能使一些患者避免行气管切开术。22例无需呼吸机支持的患者神经肌肉损伤明显较轻，仅有轻微的颅神经病变，未发生肺炎，在19.1±4.6天后出院。81%的患者功能恢复良好。GBS患者临床表现和严重程度差异很大，这就要求主治医师在处理每一个病例时要灵活，不能参照假设的“典型病例”随意做出管理决策。
