Coakley J H, Nagendran K, Honavar M, Hinds C J
Intensive Therapy Unit, St. Bartholomew's Hospital, West Smithfield, London, UK.
Intensive Care Med. 1993;19(6):323-8. doi: 10.1007/BF01694705.
To estimate the incidence and nature of neuromuscular abnormalities in a representative group of ITU patients.
Prospective sequential study.
Teaching hospital ITU.
23 patients who eventually stayed > 7 days on ITU who had no contraindication to muscle biopsy and whose relatives gave informed consent.
Muscle histopathology, neurophysiological studies, record of all drugs administered, APACHE II score, organ system failure score, presence or absence of sepsis, clinical evaluation of neuromuscular problems, time to hospital discharge. Heterogeneous neuromuscular abnormalities were present in 22 out of 23 patients studied and included axonal neuropathy, denervation, generalised fibre atrophy, non-specific myopathy and necrotising myopathy.
Neuromuscular abnormalities are almost invariable in longstay intensive care patients and the resulting weakness may seriously delay hospital discharge. Various abnormalities were seen but no obvious aetiological factors were identified. The origin of the abnormalities is probably multifactorial.
评估一组具有代表性的重症监护病房（ITU）患者神经肌肉异常的发生率及性质。
前瞻性序贯研究。
教学医院重症监护病房。
23例最终在重症监护病房住院超过7天、无肌肉活检禁忌证且其亲属已签署知情同意书的患者。
肌肉组织病理学、神经生理学研究、所有用药记录、急性生理与慢性健康状况评分系统（APACHE II）评分、器官系统衰竭评分、是否存在败血症、神经肌肉问题的临床评估、出院时间。在23例研究患者中，22例存在异质性神经肌肉异常，包括轴索性神经病、失神经支配、广泛性纤维萎缩、非特异性肌病和坏死性肌病。
长期重症监护患者几乎都会出现神经肌肉异常，由此导致的肌无力可能会严重延迟出院。观察到多种异常情况，但未发现明显的病因。这些异常的起源可能是多因素的。
