危篤な疾患 ミオパシーとニューロパシー
N Latronico1, F Fenzi, D Recupero
1Instituto di Anestesia-Rianimazione, Spedali Civili, Università di Brescia, Italy.
Lancet (London, England)
|June 8, 1996
まとめ
重症で昏睡状態にある患者は,神経筋疾患 (NMD) による麻痺を発症することがあります. 電気神経ミオグラフィ (ENMG) による早期診断は,重度のセプシス症例でも,管理と予後にとって極めて重要です.
科学分野:
- 神経学 神経学とは
- クリティカルケア・メディシン
- 病理学 パトロジー
背景:
- セプシスと多臓器不全の重症患者は麻痺を経験することがあります.
- 周辺神経および筋肉疾患 (NMD) は,これらの患者における麻痺の潜在的な原因です.
研究 の 目的:
- 麻痺状態の昏睡状態の患者における神経筋肉疾患 (NMD) を調査する.
- エレクトロニューロミオグラフィ (ENMG) と筋肉神経生検の診断価値を判断するために.
主な方法:
- 電気ニューロミオグラフィ (ENMG) と筋神経生検は,麻痺と深反射の欠如の昏睡状態の患者に実施されました.
- セプシスの持続時間,臓器機能不全,生化学マーカー,薬剤などの臨床データを記録した.
主要な成果:
- 24人の患者は四肢症または四肢麻痺を発症し,23人の筋肉の変化がありました.
- アクソナル神経症は22人の患者のうち8人に確認されました.
- セプシスと臓器機能障害は一般的であったが,特定の薬剤は完全に麻痺と関連づけられず,高血糖症/低アルバミネミアの役割は不明であった.
結論:
- 昏睡状態の患者は,NMDにより完全な麻痺を経験することがあります.
- ENMGは,重症治療におけるNMDの診断,管理の指導,不要な検査の回避に不可欠です.
- 筋神経生検は,特定のNMD分類を必要とする症例に限定されています.
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