儿科重症监护病房获得性肌无力的研究进展

doi:10.12372/jcp.2026.26e0158

临床儿科杂志 ›› 2026, Vol. 44 ›› Issue (8): 761-768.doi: 10.12372/jcp.2026.26e0158

• 文献综述 • 上一篇

儿科重症监护病房获得性肌无力的研究进展

丁秋元¹^,³^,⁴^,⁵, 周亮²^,³^,⁴^,⁵()

¹ 重庆医科大学附属儿童医院重症医学科
² 重庆医科大学附属儿童医院急诊科
³ 儿童少年健康与疾病国家临床医学研究中心
⁴ 儿童发育疾病研究教育部重点实验室
⁵ 儿童医疗大数据智能应用重庆市高校工程研究中心（重庆 400014 ）

收稿日期:2026-02-09 修回日期:2026-03-27 录用日期:2026-06-22 出版日期:2026-08-15 发布日期:2026-08-03
通讯作者: 周亮 E-mail:756716589@qq.com
作者简介:第一联系人：作者贡献（Authors’ Contributions）
丁秋元负责文献筛选、资料提取、论文撰写；周亮负责研究指导、论文修改。

Research progress of pediatric intensive care unit-acquired weakness

DING Qiuyuan¹^,³^,⁴^,⁵, ZHOU Liang²^,³^,⁴^,⁵()

¹ Department of Intensive Care Unit Children's Hospital of Chongqing Medical University
² Department of Emergency Children's Hospital of Chongqing Medical University
³ National Clinical Research Center for Children and Adolescents' Health and Diseases
⁴ Ministry of Education Key Laboratory of Child Development and Disorders
⁵ Intelligent Application of Big Data in Pediatrics Engineering Research Center of Chongqing Education Commission of China, Chongqing 400014, China

Received:2026-02-09 Revised:2026-03-27 Accepted:2026-06-22 Published:2026-08-15 Online:2026-08-03
Contact: ZHOU Liang E-mail:756716589@qq.com

摘要/Abstract

摘要：

重症监护病房获得性肌无力（ICU-AW）是患者在危重疾病期间发生的继发性神经肌肉综合征，主要表现为新发肢体对称性肌无力、肌肉萎缩和脱机困难。这一疾病在成人患者中已得到充分的重视。但是，ICU-AW在危重症儿童中的报道较少，儿科重症监护病房（PICU）对该病的认识尚有欠缺。因此，本文综述了关于ICU-AW的儿科领域文献，从流行病学、危险因素、病理生理学、诊断标准及方法、预防和治疗等方面全面总结目前学界对儿科ICU-AW的认识。现阶段，关于儿童ICU-AW的研究尚不充分，诊断标准不统一，提示需要进一步的临床研究以加深并统一对该疾病的认识。减少PICU-AW发生的危险因素以及早期活动、减少镇静和神经肌肉电刺激治疗，可能是预防和治疗PICU-AW的有效措施。

关键词: 儿科, 重症监护病房获得性肌无力, 危重病性多发性神经病, 危重病性肌病, 临床特征

Abstract:

Intensive care unit-acquired weakness (ICU-AW) is a secondary neuromuscular syndrome occurring during critical illness, mainly manifesting as new-onset symmetrical limb weakness, muscle atrophy, and difficulty weaning from ventilation. This condition is well recognized in adult patients. However, there are few reports of ICU-AW in critically ill children, and awareness of the disease remains inadequate in the pediatric intensive care unit (PICU). Therefore, this article reviews the pediatric literature on ICU-AW and comprehensively summarizes the current academic understanding of pediatric ICU-AW in terms of epidemiology, risk factors, pathophysiology, diagnostic criteria and methods, and prevention and treatment. At this stage, research on pediatric ICU-AW is still insufficient with no unified diagnostic criteria, indicating that further clinical studies are required to deepen and unify the understanding of this disease. Reducing the risk factors for PICU-AW, as well as early mobilization, reduced sedation, and neuromuscular electrical stimulation therapy, may be effective measures for the prevention and treatment of PICU-AW.

Key words: pediatric, intensive care unit-acquired weakness, critical illness polyneuropathy, critical illness myopathy, clinical features

中图分类号:

丁秋元, 周亮. 儿科重症监护病房获得性肌无力的研究进展[J]. 临床儿科杂志, 2026, 44(8): 761-768.

DING Qiuyuan, ZHOU Liang. Research progress of pediatric intensive care unit-acquired weakness[J]. Journal of Clinical Pediatrics, 2026, 44(8): 761-768.

图/表 1

参考文献 39

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项目	危重病性多发性神经病	危重病性肌病
临床特征	肌力减弱，腱反射减弱或消失。可能出现远端感觉丧失（大/小神经纤维受累）	肌肉明显萎缩，但腱反射正常
神经电生理检查	神经源性损害。①神经传导：CMAPs和SNAPs波幅降低；②肌电图：纤颤电位（急性失神经表现）	肌源性损害。①神经传导：CMAPs波幅降低，感觉神经传导正常；②肌电图：短时限、多相运动单位电位
肌肉/神经活检	神经纤维水肿/肿胀，伴有轴突变性	Ⅱ型肌纤维萎缩。粗肌丝（肌球蛋白）丢失（特征性但非总是可见）

儿科重症监护病房获得性肌无力的研究进展

Research progress of pediatric intensive care unit-acquired weakness

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