Nhận diện sớm và dự phòng biến chứng ở bệnh nhân hội chứng Guillain – Barrè=Early identification and prevention of complications in patients with Guillain

Nhận diện sớm và dự phòng biến chứng ở bệnh nhân hội chứng Guillain – Barrè=Early identification and prevention of complications in patients with Guillain - Barrè syndrome

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Tác giả: Thị Thu Huyền Nguyễn, Tuấn Lượng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.347-354

Bộ sưu tập: Metadata

ID: 477909

Thêm vào giỏ

Early identification of manifestations in patients with Guillain - Barrè syndrome (GBS) thereby helping to prevent complications that may occur in this group of diseases. Method: Retrospective study with clinical characteristics and symptom improvement effectiveness when treating with plasma exchange (PE) for GBS patients at Viet Tiep Friendship Hospital from May 2021 to May 2024. Results: We analyzed 62 patients: male (59.68%), age (47.07 ± 17.15), female (40.32%), age (48.32 ± 18.91). When comparing the time of disease onset to hospital admission in the group before 7 days and after 7 days, it was found that: patients with symmetrical paralysis, in the lower limbs accounted for a high proportion upon admission (84.61% and 95.65%, P<
0.05), and had a rapid progression (61.53% and 78.26%, P<
0.05). In addition, electromyography showed early changes in F waves and H reflexes (87.18% and 91.3%, P<
0.05), along with protein cell dissociation in the cerebrospinal fluid (41.02% and 82.61%, P<
0.05) as early signs of this disease. Plasma exchange after admission was 2.27 ± 0.39 days, helping to restore muscle strength assessed by MRC scale and GDS scale, improving well in the young age group (<
40 years old) when performed at 7 days from the time of onset of the disease (P<
0.05). Conclusion: Age at admission, the nature of the symmetrical paralysis spreading upward, the characteristics of electromyographic changes (F wave and H reflex) and protein cell dissociation in the cerebrospinal fluid are early signs of recognition. Early plasma exchange helps reduce the risk of possible complications.Nhận diện sớm những biểu hiện ở bệnh nhân hội chứng Guillain - Barrè (GBS) từ đó giúp dự phòng biến chứng có thể xảy ra ở nhóm bệnh lý này. Phương pháp: Nghiên cứu hồi cứu lâm sàng và hiệu quả cải thiện triệu chứng khi điều trị thay huyết tương (PE) cho bệnh nhân GBS tại bệnh viện Hữu nghị Việt Tiệp từ tháng 05 năm 2021 đến tháng 05 năm 2024. Kết quả: Phân tích 62 bệnh nhân: nam (59,68%), tuổi (47,07 ± 17,15) và nữ (40,32%), tuổi (48,32 ± 18,91). Biểu hiện lâm sàng giữa thời gian khởi phát bệnh đến khi vào viện ở nhóm trước 7 ngày và sau 7 ngày nhận thấy: liệt có tính đối xứng, ở chi dưới khi nhập viện chiếm (84,61% và 95,65%, P<
0,05)
liệt lan lên nhanh (61,53% và 78,26%, P<
0,05). Điện cơ có biến đổi sớm của sóng F và phản xạ H (87,18% và 91,3%, P<
0,05)
Dịch não tủy phân ly đạm tế bào (41,02% và 82,61%, P<
0,05) là những dấu hiệu nhận biết sớm bệnh lý này. Thay huyết tương sau nhập viện là 2,27 ± 0,39 ngày giúp phục hồi sức cơ đánh giá qua thang điểm MRC và thang điểm GDS cải thiện tốt ở nhóm tuổi trẻ (<
40 tuổi) khi thực hiện trong vòng 7 ngày tính từ thời điểm khởi phát bệnh (P<
0,05). Kết luận: Tuổi, liệt đối xứng lan lên, thay đổi điện cơ (sóng F và phản xạ H) và phân ly đạm tế bào trong dịch não tủy là dấu hiệu nhận diện sớm. Thay huyết tương càng sớm giúp giảm nguy cơ biến chứng có thể xảy ra.

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