危症後多發性神經肌肉病變之吞嚥困難：病例報告

危症後多發性神經肌肉病變是危症後病人常見的併發症。然而，目前並沒有此類病人發生持續吞嚥困難的相關文獻。此外，對於糖尿病病患發生嚴重吞嚥困難的情況也是罕見的。我們報告了一位女性糖尿病患個案，由於嚴重的肺炎併發呼吸衰竭後產生廣泛性的肌肉無力的現象。核磁共振掃描排除了腦部病灶的可能性。而患者的神經傳導及肌電圖檢查則證實了多發性神經病變及肌肉病變。儘管經過復健訓練後個案的四肢肌力恢復到接近正常，我們發現患者仍舊持續有吞嚥障礙。而螢光錄影吞嚥檢查也顯示出嚴重的口咽部吞嚥困難。危症後的病人有可能高達70%至80%的機會罹患危症後多發性神經肌肉病變，然而此病症在近年來才逐漸的被重視，目前對其致病原因以至於治療的方法仍有諸多未明之處。因此，未來仍迫切需要有更多相關的研究。

關鍵字

危症後多發性神經肌肉病變；吞嚥困難；糖尿病

並列摘要

Critical illness polyneuropathy and myopathy (CIPNM) is a common complication seen in patients with critical illness. However, long-lasting oropharyngeal dysphagia in patients with CIPNM has not been reported previously. Besides, severe dysphagia is also a rare condition in patients with diabetes. Here, we present the case of a woman with diabetes, who developed neuromuscular weakness after recovery from severe pneumonia and respiratory failure. Brain lesion was excluded by magnetic resonance imaging of brain. CIPNM was confirmed by nerve conduction and electromyographic studies. Videofluoroscopic swallow study showed severe oropharyngeal dysphagia. The general weakness and functional status improved gradually after rehabilitation. However, the dysphagia persisted and she required tubal feeding. Although the pathogenesis of CIPNM is still not well known, adequate rehabilitation program could be beneficial for improving the function of these patients.

並列關鍵字

critical illness polyneuropathy and myopathy ； dysphagia ； diabetes mellitus

國際替代計量

危症後多發性神經肌肉病變之吞嚥困難：病例報告

全文下載

主題瀏覽