术后Guillain-Barré综合征的临床与电生理特征分析:一项单中心回顾性研究OA

Objective To investigate the clinical features,electrophysiological subtypes,and prognosis of surgery-related Guillain-Barré syndrome(GBS),to improve clinical recognition and diagnostic accuracy of the disease.Methods This was a retrospective case-control study.The observation group incorporated 21 patients diagnosed with post-surgical GBS at our hospital from January 2015 to September 25.And 70 non-surgical GBS patients hospitalized during the same period and 30 healthy volunteers were collected as control.Clinical data were collected for both groups,including clinical manifestations,electrophysiological findings,CSF results,and prognostic indicators.The incidence of respiratory failure,autonomic dysfunction,muscle atrophy,and Hughes functional grading scale(HFGS)scores were compared,and electrophysiological subtypes were analyzed.Results The median onset time of GBS symptoms after surgery was 15 d.The main types of preceding surgeries included orthopedic,gastrointestinal,neurosurgical,and gynecological operation.All patients presented with respiratory muscle weakness in the distal limbs.Compared to the non-surgical GBS patients,the post-surgical GBS patients showed significantly higher rates of respiratory failure,autonomic dysfunction,muscle atrophy,and HFGS scores(all P＜0.05).Electrophysiological findings indicated that post-surgical GBS patients exhibited a significant reduction in compound muscle action potential amplitudes compared with the healthy control group(all P＜0.05),while motor nerve conduction velocity and distal latency were relatively preserved,suggesting that the predominant pathological subtype was acute motor axonal neuropathy.Conclusions Surgery may be an important non-infectious trigger for GBS.Rapidly progressive symmetrical limb weakness in post-surgical patients should raise suspicion for GBS.Early electrophysiological and CSF examinations are recommended to facilitate timely diagnosis and intervention,thereby improving patient outcomes.