ICU重症多神经肌病诊治探讨(附4例报告)

CRITICAL ILLNESS POLY-NEUROMYOPATHY IN THE INTENSIVE CARE UNIT:A REPORT OF FOUR CASES

目的探讨重症病人治疗期间发生重症多神经肌病相关危险因素及其诊断和治疗。方法回顾性分析近3年我科收治外科术后重症病人治疗过程中发生重症多神经肌病4例的临床资料。结果重症多神经肌病的诊断主要依据其临床表现、结合病史及相关辅助检查,其中多器官功能衰竭综合征是导致其发生的最强独立危险因素。本组3例病人治愈,肢体活动功能恢复良好,徒手肌力评分>48分;另1例目前仍在康复治疗中。结论重症多神经肌病可引起严重肌无力,导致延迟撤机,增加ICU住院时间和病死率,防治以去除致病危险因素、加强床旁功能康复等综合措施为主。

Objective To explore the related risk factors, diagnosis and therapy ot critical poly-neuromyopathy occurred in patients during being treated in the intensive care unit （ICU）. Methods From April 2010 to September 2013, four patients were diagnosed with critical poly-neuromyopathy during their stay in the ICU after surgery. The clinical data were reviewed retro- spectively. Results The diagnosis of critical illness poly-neuromyopathy was mainly based on the clinical manifestations, case history, and auxiliary examinations, of which, multiple organ failure was the most important independent risk factor. Three pa tients in this group had been cured, one still received rehabilitation care. Conclusion Critical poly-neuromyopathy may cause severe myasthenia, leading to delayed removal of breathing machine and increase of ICU stay and mortality. The prevention and cure should mainly focus the risk factors that cause the disease and enhancing beside functional rehabilitation.