KẾT QUẢ THAY HUYẾT TƯƠNG CHO BỆNH NHÂN HỘI CHỨNG GUILLIAN – BARRÉ VÀ NHƯỢC CƠ TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: The study aimed to describe the clinical characteristics, effectiveness of plasma exchange therapy, and potential complications during treatment in patients with myasthenia gravis and Guillain-Barré syndrome. Methods: This was a retrospective, descriptive study of patient medical records. Results: The study included 45 patients, of which 32 had Guillain-Barré syndrome (71.1%) and 13 had myasthenia gravis (28.9%). The male-to-female ratio was 22/23. A total of 237 plasma exchange sessions were performed: 114 using fresh frozen plasma and 123 using 5% albumin. Muscle strength in the major muscle groups improved after the treatment. There were 26/237 (11%) cases of anaphylaxis, with 23 of these occurring during plasma exchange using fresh frozen plasma, requiring a switch to 5% albumin. Seven cases required termination of the procedure due to anaphylaxis. Other complications observed included pneumonia (17.8%), catheter-related infections (4.2%), significant bleeding (2.1%), and filter clogging (0.8%). In the Guillain-Barré group, 6/32 patients required invasive ventilation; the average number of plasmapheresis sessions was 5.3±0.9; and 87.5% of patients showed significant improvement based on the Hughes scale. In the myasthenia gravis group, 7/13 patients required invasive ventilation; the average number of plasma exchange sessions was 5.3±1.6; and 92% of patients showed significant improvement based on the Myasthenia Gravis Composite (MGC) scale. Conclusion: Plasma exchange improves muscle weakness in patients with myasthenia gravis and Guillain-Barré syndrome. The procedure is generally safe, with anaphylaxis being the most common complication, most of which were mild.