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目的探讨格林-巴利综合征婴儿期的发病特点,以求及早诊断,及早治疗。方法回顾性分析近5年来15例小婴儿患本病的小婴儿的临床资料,包括患儿一般资料、临床症状体征、治疗及转归,体会对本病的高度警惕性是拟诊的关键环节。结果13例丙球冲击抗感染治疗5天后,病情好转稳定不再进展,6例严重呼吸困难,1例气管插管机械通气8天,顺利撤机。无1例气管切开。所有病例均并发肺部感染,经抗感染气道管理,肺炎治愈。肢体功能障碍于发病1周,肌力逐渐恢复改善,平均住院日42天,一个月后随访,生长发育肢体功能均无异常。结论婴儿期格林-巴利综合征缺乏典型的临床表现,首发异常多表现呛奶、声哑、咳嗽、呼吸困难、发绀,而肢体无力早期不易被发现,容易误诊,要求医生查体要细心,询问病情要耐心,多可获得有价值的临床资料。早期丙球冲击治疗是治疗关键,而呼吸管理显得尤为重要,有上机指征要及时机械通气呼吸支持,并要防止呼吸机相关的肺损伤,适时撤机。
Objective To investigate the incidence of Guillain-Barre syndrome in infancy, in order to early diagnosis and early treatment. Methods The clinical data of 15 infants with this disease in our hospital from last 5 years were retrospectively analyzed. The general information, signs and symptoms, treatment and prognosis of children with this disease were reviewed. The high vigilance against this disease was the key link of the proposed diagnosis . Results After 13 days of anti-infection of c-ball impact resistance, the condition was no longer stable, 6 cases of severe dyspnea and 1 case of mechanical endotracheal intubation for 8 days were successfully weaned. No case of tracheotomy. All cases were complicated by pulmonary infection, anti-infective airway management, pneumonia cure. One week after the onset of limb dysfunction, muscle strength gradually recovered and improved. The average length of hospitalization was 42 days. One month after follow-up, there was no abnormality in limb function. Conclusion The onset of Guillain-Barre syndrome in infancy is characterized by a lack of typical clinical manifestations. The first episode of abnormality often results in choking, dumbness, coughing, dyspnea, cyanosis. However, limb weakness is not easily detected early and is easily misdiagnosed. Ask the patient to be patient and get valuable clinical information. Early ball impact treatment is the key to treatment, and respiratory management is particularly important, there are prompt indications of mechanical ventilation and respiratory support, and to prevent ventilator-related lung injury, timely weaning.