儿童感染性疾病的重症多发性神经病

V. Voitenkov, A. Klimkin, N. Skripchenko, A. Vilnits
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摘要

我们的目的是建立感染性疾病患儿重症多发性神经病的电生理特征。材料与方法:对67例不同类型感染性疾病(病毒性脑炎、脑膜脑炎、脑膜炎、急性胃肠炎)重症患儿的周围神经系统受累情况进行评估。年龄从4个月到17岁不等。所有患者均行传导研究和神经学检查。对尺骨棘和正中棘的感觉纤维和运动纤维、胫棘的运动纤维和水棘的感觉纤维进行了检测。运动纤维和感觉纤维的振幅降低、传导速度减慢和不对称是主要原因。结果:47例(71例)确诊为重症多发性神经病(CIP)。病变主要累及下肢神经。根据我们的数据,所有病例中有40%出现严重的CIP病程。患儿CIP发病的平均时间为机械通气开始后5 ~ 7天。结论:感染性疾病患儿重症多发性神经病变是一种严重的疾病,可导致患者致残。71%的患者平均发病时间为开始机械通气后5 ~ 7天。更常见的是下肢神经的感觉和运动纤维受到影响。传导研究是确定感染性疾病患儿重症多发性神经病变诊断过程中有价值的工具。关键词:危重症,危重症多发性神经病,儿童,肌电图
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Critical Illness Polyneuropathy in Children with Infectious Diseases
Our goal was to establish electrophysiological features of critical illness polyneuropathy in children with infectious diseases. Materials and Methods: We evaluated peripheral nervous system involvement in 67 critically ill children, admitted in ICU with different types of infectious diseases (viral encephalitis, meningoencephalitis, meningitis, acute gastroenteritis). Age of the group varied from 4 months to 17 years. All patients underwent conduction studies and neurological investigation. Sensory and motor fibers of n. ulnaris et n. medianus, motor fibers of n. Tibialis and sensory fibers of n. Suralis were tested. Lowering of the amplitudes, conduction velocity slowing and asymmetry were accounted for the motor and sensory fibers. Results: In 47 cases (n=71) diagnosis of critical illness polyneuropathy (CIP) was established. Lesions mostly involved lower limbs nerves. According to our data, severe course of CIP was seen in 40% of all cases. Average time of CIP onset in children was 5-7 days from the beginning of mechanical ventilation. Conclusions: Critical illness polyneuropathy in children with infectious diseases is a severe condition which may lead to the disability of the patients. Average time of its onset is the 5-7 days from the beginning of the mechanical ventilation in 71% of the patients. More often sensory and motor fibers of lower limbs nerves are affected. Conduction studies is a valuable tool in diagnostic process in establishing the critical illness polyneuropathy in children with infectious diseases. Keywords: Critical illness, critical illness polyneuropathy, children, electromyography.
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