{"title":"成年格林-巴罗综合征患者康复后三年随访结果","authors":"Fatma Ballı Uz, Cuma Uz, Ozgur Zeliha Karaahmet","doi":"10.4314/mmj.v35i3.4","DOIUrl":null,"url":null,"abstract":"Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Three-year follow-up outcomes of adult patients with Guillain-Barré Syndrome after rehabilitation\",\"authors\":\"Fatma Ballı Uz, Cuma Uz, Ozgur Zeliha Karaahmet\",\"doi\":\"10.4314/mmj.v35i3.4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.\",\"PeriodicalId\":18185,\"journal\":{\"name\":\"Malawi Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Malawi Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4314/mmj.v35i3.4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Malawi Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4314/mmj.v35i3.4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
吉兰-巴罗综合征(GBS)是急性麻痹性神经病变最常见的病因,涵盖了许多可识别的不同变体。我们的目的是评估GBS患者的临床特征和患者康复后的结果。方法:我们招募了24例成年GBS患者,并在入院、出院、1年和3年随访期间评估他们的人口统计学特征、体征、并发症、功能水平和残留症状。采用功能独立量表(FIM)、功能步行量表(FAS)、Hughes功能分级量表、6分钟步行测试(6MWT)和疲劳严重程度量表(FSS)对患者进行评估。结果本组患者平均年龄47.29±16.2岁,其中女性占40%,平均住院时间28.91±25.6天。这些患者的主要症状是疲劳(100%)、神经性疼痛(70.8%)、关节疼痛(54.2%)和自主神经功能障碍(50%)。入院、出院和1 /3年随访时,FIM、Hughes功能分级量表、FAS、6MWT和MRC评分均发生显著变化(p=0.000, p=0.000, p=0.000, p=0.001, p=0.000)。随着年龄的增长,疲劳和休斯评分显著增加(p=0.019, r=0.475;P =0.041, r=0.419)。1年随访时,年龄与FAS、6MWT、MRC评分呈负相关(p=0.025, r=-0.456;p = 0.027, r = -0.450;p = 0.008, r = -0.528)。入院前FSS≥4分,随访3年时FSS≥53.1%,与6MWT、MRC总分呈负相关。GBS临床分型差异无统计学意义。结论康复治疗可改善GBS患者的功能,并可观察到远期疗效。然而,尽管功能改善,残余症状如疲劳和神经性疼痛可能持续存在。这些发现强调了将康复纳入GBS管理和解决残留症状以改善患者预后的重要性。
Three-year follow-up outcomes of adult patients with Guillain-Barré Syndrome after rehabilitation
Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.
期刊介绍:
Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region.
Topics covered in the journal include, but are not limited to:
- Communicable diseases (HIV and AIDS, Malaria, TB, etc.)
- Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.)
- Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.)
- Mental health
- Environmental health
- Nutrition
- Health systems and health policy (Leadership, ethics, and governance)
- Community systems strengthening research
- Injury, trauma, and surgical disorders