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ICU患者发生肌无力情况普遍，导致住院时间延长、脱机困难，死亡风险增加。及时鉴别肌无力病因并进行针对性治疗是关键。本例患者系重症肺炎诱发糖尿病酮症酸中毒（diabetic ketoacidosis,DKA），感染控制、DKA纠正后出现肌无力进行性加重并累及呼吸肌，结合查体、并完善脑脊液检查、肌电图检查后诊断吉兰-巴雷综合征（Guillain-Barrésyndrome,GBS），给于血浆置换后序贯免疫球蛋白治疗，患者肢体肌力逐渐恢复并成功脱机，最后好转出院。此病例提示临床医生，在ICU患者中出现肌无力时，要完善检查，及时鉴别病因，给于病因治疗，警惕除常见的ICU获得性肌无力（ICU-acquired weakness,ICU-AW）外其他可以导致肌无力的原因，如GBS。
Abstract：Muscle weakness in ICU patients is common, often leading to prolonged hospital stays, difficulty weaning off mechanical ventilation, and increased risk of mortality. Timely identification of the cause of muscle weakness and targeted treatment are crucial. In this case, the patient developed muscle weakness progressing to respiratory muscle involvement after severe pneumonia induced diabetic ketoacidosis(DKA)was controlled and corrected. By physical examination, cerebrospinal fluid analysis, and electromyography, Guillain-Barré syndrome( GBS) was diagnosed. The patient was treated with intravenous immunoglobulin after plasma ex change therapy, leading to gradual recovery of limb strength and successful weaning off respiratory support,resulting in discharge with improvement. This case highlights the importance for doctors to thoroughly investigate the cause of muscle weakness in ICU patients, not only common ICU-acquired weakness(ICU-AW), such as considering GBS as a potential cause.
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基本信息:
DOI：10.20256/j.cnki.zgdxbl.20250205.002
中图分类号:R563.1;R745.43;R587.2
引用信息:
[1]赵玉杰,张静静,王小闯.重症肺炎合并糖尿病酮症酸中毒继发吉兰-巴雷综合征1例[J].中国典型病例大全,2025,19(01):8-10.DOI:10.20256/j.cnki.zgdxbl.20250205.002.
基金信息: