Zipper Method in the Treatment of Severe Guillain–Barré Syndrome in Adults

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2025-09-04 DOI:10.1155/ane/2772197

Rong Lai, Yanling Pu, Huiyu Feng, Haiyan Wang, Xunsha Sun, Li Feng, Cunzhou Shen, Yusheng Liu, Shengxian Yang, Hongyan Zhou

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引用次数: 0

Abstract

Objective: This study was aimed at evaluating the efficacy of the “zipper method,” a novel treatment strategy combining alternating plasma exchange (PLEX) and intravenous immunoglobulin (IVIG) pulse therapy, in adult patients with severe Guillain–Barré syndrome (GBS) requiring mechanical ventilation.

Methods: A retrospective analysis was conducted on seven adult patients diagnosed with severe GBS and treated with mechanical ventilation from June 2022 to August 2023. Three received the “zipper method” (alternating PLEX and IVIG pulse therapy), and the other four were treated with the classic method (PLEX followed by IVIG pulse therapy). Clinical outcomes, including duration of continuous mechanical ventilation (CMV), length of stay (LOS) in the ICU, total hospital stay, muscle strength recovery as measured by the Muscle Research Council (MRC) score, and Guillain–Barré Syndrome Disability Scale (GBS-DS) and days to unaided walking, were compared between the two groups.

Results: The “zipper method” group exhibited significant improvements in clinical outcomes compared to the classic method group. Specifically, the duration of CMV was reduced to 17.67 days, the LOS in the ICU was 22.33 days, the mean days to hospital discharge were 40.67 days, and the MRC score at 1 month was 43.67 and at 2 months was 56.67. Furthermore, the GBS-DS score at 2 months posttreatment was 1.00 and the mean days to unaided walking were 80.6 days, indicating a marked reduction in disability.

Conclusion: The “zipper method” offers a promising new approach for the treatment of severe GBS in adults, leading to faster recovery of muscle strength and shorter ICU stays and length of hospital stay. This treatment strategy has the potential to improve patient outcomes and reduce the burden of severe GBS on healthcare systems. Further research, including prospective studies and randomized controlled trials, is warranted to validate these findings and explore the broader applicability of the “zipper method” in adult GBS treatment.

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拉链法治疗成人严重格林-巴-罗综合征

目的：本研究旨在评估“拉链法”，一种结合交替血浆置换（PLEX）和静脉免疫球蛋白（IVIG）脉冲治疗的新型治疗策略，对需要机械通气的严重格林-巴- 综合征（GBS）成人患者的疗效。方法：回顾性分析2022年6月至2023年8月诊断为重型GBS并接受机械通气治疗的7例成人患者。其中3例采用“拉链法”（PLEX + IVIG脉冲交替治疗），其余4例采用经典方法（PLEX + IVIG脉冲治疗）。比较两组患者的临床结果，包括持续机械通气时间（CMV）、ICU住院时间（LOS）、总住院时间、肌肉研究委员会（MRC）评分测量的肌力恢复、格林-巴罗综合征残疾量表（GBS-DS）和独立行走天数。结果：与经典方法组相比，“拉链法”组的临床疗效有显著改善。其中CMV持续时间减少至17.67天，ICU住院时间为22.33天，平均出院时间为40.67天，1个月MRC评分为43.67,2个月MRC评分为56.67。此外，治疗后2个月的GBS-DS评分为1.00，独立行走的平均天数为80.6天，表明残疾明显减少。结论：“拉链法”为成人重症GBS的治疗提供了一种有希望的新方法，可使肌力恢复更快，缩短ICU住院时间和住院时间。这种治疗策略具有改善患者预后和减轻严重GBS对卫生保健系统负担的潜力。进一步的研究，包括前瞻性研究和随机对照试验，有必要验证这些发现，并探索“拉链法”在成人GBS治疗中的更广泛适用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.