《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (01): 27-29.

• 专题 • 上一篇    下一篇

危重病性多发性神经病与肌病的临床、电生理以及病理特点

姚生1;冯立群2;戚晓昆1;雷霞1;袁云3   

  1. 1.北京海军总医院神经内科,北京市 100037;2.首都医科大学附属北京安贞医院神经内科,北京市 100029;3.北京大学第一医院神经内科,北京市 100034
  • 收稿日期:2008-10-20 出版日期:2009-01-01 发布日期:2009-01-01

Clinical, Electrophysiological and Pathologic Features of Critical Illness Polyneuropathy and Myopathy: 3 Cases Report

YAO Sheng, FENG Li-qun, QI Xiao-kun, et al   

  1. Department of Neurology, Navy General Hospital, Beijing 100037, China
  • Received:2008-10-20 Published:2009-01-01 Online:2009-01-01

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摘要： 目的 探讨危重病性多发性神经病与肌病的临床、电生理以及病理特点。方法 对3例危重病性多发性神经病与肌病患者的临床资料、肌电图结果以及神经和肌肉的病理改变特点进行分析。结果 3例患者均进行了气管插管后呼吸机辅助呼吸；插管7～10 d，患者均出现了四肢肌肉力弱及腱反射低下，14 d后出现四肢肌肉萎缩者2例。肌电图结果示四肢多条运动和感觉神经传导减慢，部分运动神经复合肌肉动作电位波幅下降。神经活检可见有髓神经纤维减少和轴索再生现象；肌肉活检提示神经源性损害及肌病样改变。结论 危重病性多发性神经病与肌病是重症患者气管插管后常见的并发症，电生理和神经肌肉病理检查有助于本病的诊断，预防本病的发生非常重要。

关键词: 危重病性多发性神经病与肌病, 电生理, 病理, 诊断

Abstract: Objective To investigate the clinical, electrophysiological and pathological features of critical illness polyneuropathy and myopathy (CIPNM). Methods The clinical outcomes, electromyogram Results as well as pathological features in nerves and muscles of 3 patients with CIPNM were investigated and analyzed. Results 3 patients were all provided with assisted respiration after tracheal intubation. 7～10 d after intubation, all the patients emerged muscle strength and tendon reflexes of extremities weakening; while 14 days after that, 2 patients appeared amyotrophy of extremities. Electromyogram showed that the conduction of many motor and sensory nerves for extremities decreased, while the amplitude of compound muscle action potential (CMAP) of part of motor nerves decreased. Biopsy for nerves revealed decreased medullated nerve fibers and regeneration phenomenon of auxiliary fibers; while that for muscles showed neuralgic damage and myopathy-like changes. Conclusion CIPNM can complicate after tracheal intubation. The electrophysiological and pathological examinations for nerves and muscles can be helpful for the diagnosis.

Key words: critical illness polyneuropathy and myopathy (CIPNM), electrophysiology, pathology, diagnosis