目的　探讨儿童吉兰-巴雷综合征（GBS）诊断延误的影响因素及其对预后的影响。方法　回顾分析118例 GBS患儿的临床资料，包括经典型GBS 100例及变异型GBS 18例[变异型中Miller-Fisher综合征（MFS）13例，头颈肩 型吉兰-巴雷综合征（PCB） 5例]。将患儿分为首诊诊断为GBS组及首诊未诊断为GBS组，并对两组进行对比。结果　 在118例GBS患儿中，首诊诊断为GBS组76例，首诊未诊断为GBS组42例。与首诊未诊断为GBS组相比，首诊诊断为 GBS组患儿肌肉力弱及典型肌肉力弱的比例较高，而肢体疼痛和呼吸功能受损的比例较低，初次就诊进行神经系统检查 的比例较高，短期预后较好，发病至开始治疗时间较短，差异均有统计学意义（P<0.05）。 与经典型GBS组相比，变异型 GBS组患儿行走不稳、颅神经受累的比例较高，而首诊诊断为GBS比例较低，从发病到开始治疗的时间较长，差异均有统 计学意义（P<0.05）。 结论　儿童GBS诊断延误与临床症状不典型及初次就诊未进行神经系统检查有关，诊断延误会影响 患儿的短期预后。

Objective　To investigate the factors in diagnosis delay in Guillain-Barré syndrome (GBS) and its impact on prognosis. Methods　In this study 118 GBS children including Miller-Fisher syndrome (MFS) and pharyngeal-cervical-brachial Guillain-Barré syndrome (PCB) were studied. All children included were divided into 2 groups as GBS-initially-diagnosed group (GBSid, n=76) and not-GBS-initially diagnosed group ( nGBSid, n=42) based on the initial diagnosis. Analysis was performed with age at disease onset, preceding infection, Hughes functional grading (HG), the department where the instial diaghosis is done, main complain, the days from disease onset to seeing doctor, time start to treatment, the discharge time, evaluation by a neurologist. Results　Among 118 GBS, 90 children were of classical GBS, 13 of MFS, and 6 of PCB. Atypical muscle weakness, neuropathic pain and impaired respiration function were more frequently seen in nGBSid group（P<0.05）. At the initial diagnosis, lacking of neurological evaluation was found more frequently in nGBSid group （P<0.05）. The duration from onset to the commencement of treatment was longer in nGBSid group than that in GBSid group（P<0.05）, and short term prognosis was poor in GBSid group (P<0.05). Conclusions　Atypical main complaints including neuropathic pain, the impaired respiration function and atypical muscle weakness, and lack of neurological evaluation were all associated with a delay in considering the diagnosis of GBS. The delay in diagnosis had a significant impact on short term prognosis.