Difficult Weaning Due to Guillain-Barre Syndrome: A Case Report and Literature Review

基安－巴瑞症候群造成的困難拔管案例：病例報告及文獻回顧

李其澧(Chi-Li Li) ； 王家弘(Jia-Horng Wang)

《胸腔醫學》 25卷2期 (2010/04) Pp. 73-77

https://doi.org/10.29806/TM.201004.0004

摘要

基安－巴瑞症候群（Guillain-Barre syndrome）是一種以急性發作，對稱性，上行性肌肉無力表現的脫髓鞘多神經病變。診斷基-巴瑞症候群主要靠臨床表現及電生理檢查結果。但在重症病人身上，他們的急性病症的表現會使我們不易觀察到漸進性麻痺的表現，因而不易確認此病症的發生或變化。在此，我們要報告一位50歲女性一開始因肺炎及呼吸衰竭需要呼吸器支持，待肺炎痊癒後卻遇到脫離呼吸器困難。經過我們回顧病史，發現有上行性肌無力情形，腦脊髓液及電生理檢查亦呈現典型表現，我們診斷為基安－巴瑞症候群。經血漿交換後，肢體無力的情形改善，病人很快就可以成功拔除氣內管並脫離呼吸器。

關鍵字

基安－巴瑞症候群 ； 呼吸衰竭 ； 困難脫離呼吸器 ； 血漿交換

並列摘要

Guillain-Barre syndrome is an acute, symmetric, ascending paralysis disorder caused by demyelinating polyradiculoneuropathies. The diagnosis of Guillain-Barre syndrome is established by the presence of clinical findings and the results of electrophysiological studies. However, in critically ill patients, the manifestations of their acute illness may obscure the progressive paralysis, and it is difficult to recognize the onset and evolution of this syndrome. Herein, we report the case of a 50-year-old woman who required ventilatory support due to pneumonia and respiratory failure. After her pneumonia subsided, difficult weaning was noted. Her history revealed ascending paralysis. Cerebrospinal fluid analysis and electrophysiological study showed typical findings, and Guillain-Barre syndrome was diagnosed. After plasma exchange, the weakness of the limbs improved and the patient was successfully weaned from the ventilator.

並列關鍵字

Guillain-Barre syndrome ； respiratory failure ； difficult weaning ； plasma exchange