Hotz M, Mewes J, Biniek R
Neurologische Abteilung, der Rheinischen Landesklinik, Bonn.
Nervenarzt. 1997 Aug;68(8):659-63. doi: 10.1007/s001150050177.
To evaluate signs of peripheral nerve dysfunction, over a period of 31 months all patients treated for more than 14 days in our intensive care unit (ICU) had clinical and electrophysiological examination. The results of 78 patients were analysed: 53 had diseases of the central nervous system, 25 suffered from general cerebral hypoxia, mainly after cardiopulmonary reanimation. 54 showed bilateral signs of denervation activity, additionally 10 patients had fibrillation potentials unilateral to their spastic hemiparesis. 19 patients had denervation potentials only in proximal muscles of the upper limbs. Generalized denervation activity developed mainly after septic organ failure. On the other hand 35 patients showed denervation potentials already between day 14 and 21, suggesting an affection of peripheral nerve function in the first week of ICU treatment. Time course, pattern of distribution and frequency of electrophysiological abnormalities are not generally consistent with alterations of nutrition, metabolism or hypoxia in the course of ICU treatment. Clinical signs of peripheral nerve dysfunction were present in 40% of the patients showing denervation in the EMG.
为评估周围神经功能障碍的体征,在31个月的时间里,对我们重症监护病房(ICU)中接受治疗超过14天的所有患者进行了临床和电生理检查。分析了78例患者的结果:53例患有中枢神经系统疾病,25例主要在心肺复苏后出现全身性脑缺氧。54例表现出双侧失神经活动体征,另外10例患者在痉挛性偏瘫侧有纤颤电位。19例患者仅在上肢近端肌肉出现失神经电位。全身性失神经活动主要在感染性器官衰竭后出现。另一方面,35例患者在第14天至21天之间就已出现失神经电位,提示在ICU治疗的第一周周围神经功能就受到了影响。电生理异常的时间进程、分布模式和频率与ICU治疗过程中的营养、代谢或缺氧改变通常不一致。在肌电图显示失神经的患者中,40%存在周围神经功能障碍的临床体征。