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镰旁脑膜瘤术后并发格林巴利综合征1例

2017-12-04 佚名 中国临床神经外科杂志

脑膜瘤格林巴利综合征
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患者，女，54岁

【一般资料】

患者，女，54岁

【主诉】

除头痛外，无肢体感觉、运动障碍。

【现病史】

当地医院MRI检查示左侧大脑镰旁中1/3脑膜瘤。以顶部过中线切口行开颅脑膜瘤切除术，术后四肢感觉、运动无明显异常。术后13d突发四肢乏力，四肢肌力约Ⅱ级，双侧肌力对称，腱反射明显减弱，无明显感觉障碍。

【辅助检查】

复查CT未见颅内术腔出血或水肿、梗死征象。肌电图检查示周围神经性病变。腰椎穿刺术示蛋白细胞分离

【初步诊断】

诊断为格林巴利综合征（Guillain-Barresnydrome，GBS）

【治疗】

给予补钾、静脉输注免疫球蛋白、激素治疗未见好转。术后26d，患者出现轻度呼吸急促，呼吸费力。除上述治疗外，同时行偏瘫肢体康复训练及营养神经治疗。术后3个月，患者仍活动受限，肌力恢复为Ⅲ级，主要是近端关节处肌力有所恢复，远端关节活动仍差。

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    2018-02-04 丁鹏鹏

    #并发#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1757905, encodeId=2b161e5790558, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sun Feb 04 03:51:00 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280829, encodeId=fea31280829d5, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431027, encodeId=c42e143102eda, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267101, encodeId=f44826e1018a, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Dec 05 23:18:27 CST 2017, time=2017-12-05, status=1, ipAttribution=)]
    2017-12-06 jiangfeng5067

    #脑膜瘤#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1757905, encodeId=2b161e5790558, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sun Feb 04 03:51:00 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280829, encodeId=fea31280829d5, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431027, encodeId=c42e143102eda, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267101, encodeId=f44826e1018a, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Dec 05 23:18:27 CST 2017, time=2017-12-05, status=1, ipAttribution=)]
    2017-12-06 zhouqu_8

    #综合征#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1757905, encodeId=2b161e5790558, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sun Feb 04 03:51:00 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280829, encodeId=fea31280829d5, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431027, encodeId=c42e143102eda, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed Dec 06 08:51:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=267101, encodeId=f44826e1018a, content=非常好的文章.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Tue Dec 05 23:18:27 CST 2017, time=2017-12-05, status=1, ipAttribution=)]
    2017-12-05 天涯183

    非常好的文章.学习了

    0

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