fa بررسی اپیدمیولوژیک و بالینی فلج شل حاد در کودکان بستری در بیمارستان شهید مطهری ارومیه طی سال‌های ۱۳۹۵ تا ۱۴۰۳ نورولوژي Neurology مقاله اصیل پژوهشی Original Article <div style="text-align: justify;"><span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">زمینه و هدف:</span></b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> فلج شل حاد (</span></span>Acute Flaccid Paralysis<span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) شاخص کلیدی در نظام مراقبت فلج اطفال است و با ریشه‌کنی جهانی پولیو، شناسایی علل غیرپولیویی آن اهمیت یافت. این مطالعه با هدف بررسی ویژگی‌های بالینی، تشخیص نهایی و پیامد بیماران مبتلا به</span></span> AFP <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در کودکان بستری در بیمارستان شهید مطهری ارومیه (</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">1403-1395)</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> انجام شد</span></span><span dir="LTR" style="font-size:9.0pt">.</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">روش تحقیق:</span></b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> این پژوهش مقطعی توصیفی</span></span><span lang="AR-SA" style="font-size:11.0pt"><span arial="" style="font-family:">&ndash;</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">تحلیلی گذشته‌نگر بر روی تمام کودکان زیر </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۸</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> سال مبتلا به </span></span>AFP<span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> انجام شد. اطلاعات شامل سن، جنس، تب، مدت بستری، تشخیص نهایی، اقدامات بیمارستانی ویژه و پیامد نهایی استخراج گردید. داده‌ها با نرم‌افزار</span></span> SPSS <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نسخه </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۲۶</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و آزمون دقیق فیشر تحلیل شد و سطح معنی‌داری </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">05/0</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> در نظر گرفته شد</span></span><span dir="LTR" style="font-size:9.0pt">.</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">یافته‌ها:</span></b> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در مجموع </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۲۸۰</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> کودک بررسی شدند (میانگین سنی 77/3</span></span><span dir="LTR" style="font-size:9.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">88/9</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سال). بیشترین بروز در گروه سنی </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۶</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> تا </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">۱۲</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(2/58 درصد، 001/0></span></span>P<span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">سال مشاهده شد. شایع‌ترین تشخیص، سندرم گیلن‌باره</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> (4/66 درصد) </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بود. تفاوت معنی‌داری بین نوع تشخیص و گروه سنی مشاهده شد</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(001/0></span></span>P<span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)، اما بین جنس و تشخیص اختلاف معنی‌داری دیده نشد (385/0=</span></span>P<span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">میانگین مدت بستری 8/12</span></span><span lang="AR-SA" style="font-size:11.0pt"><span calibri="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">1/9 روز بود که در بیماران بوتولیسم به‌طور معنی‌داری طولانی‌تر بود (001/0></span></span>P<span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">4/6 درصد </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بیماران نیازمند مداخلات ویژه بودند. در زمان ترخیص، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">2/88 درصد </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بهبود کامل یافتند، </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">5 درصد</span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بدون تغییر باقی ماندند و </span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">7/0 درصد </span></span><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">فوت کردند</span></span><span dir="LTR" style="font-size:9.0pt">.</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span b="" lang="AR-SA" mitra="" style="font-family:">نتیجه‌گیری:</span></b><span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> گیلن‌باره</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">شایع‌ترین علت غیرپولیویی</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">فلج شل حاد</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در کودکان بود. با وجود تفاوت در مدت بستری، بیشتر بیماران با درمان حمایتی بهبود کامل یافتند و مرگ‌ومیر بسیار پایین بود. تقویت پایش آزمایشگاهی و پیگیری بالینی برای افزایش حساسیت نظام مراقبت</span></span> AFP <span lang="AR-SA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">توصیه می‌شود</span></span><span dir="LTR" style="font-size:9.0pt">.</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></div> <div> <div> <table align="left" hspace="0" vspace="0"> <tbody> <tr> <td style="padding: 0in 12px; text-align: justify;" valign="top"><span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><a name="_Hlk200355634"><b><span style="font-size:11.0pt">Background and Aims:</span></b></a> <span style="font-size:11.0pt"><span style="background:white"><span style="color:black">Acute flaccid paralysis (AFP) is a key indicator in poliomyelitis surveillance. With global polio eradication, identifying non-polio causes of AFP is increasingly important. This study aimed to determine the clinical characteristics, final diagnoses, and hospital outcomes of pediatric AFP cases admitted to Shahid Motahari Hospital, Urmia, Iran, from 2016 to 2024</span></span></span><span style="font-size:12.0pt">.</span><span style="font-size:11.0pt"></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Materials and Methods:</span></b><span style="font-size:11.0pt"> This retrospective, descriptive, and analytical study included all children under 18 years diagnosed with AFP and recorded in the national surveillance system. Data collected included age, gender, fever, hospitalization duration, final diagnosis, special medical interventions, and discharge outcomes. Statistical analyses were performed using SPSS software (version 26), applying Fisher&rsquo;s exact test with a significance level of P<0.05.</span></span></span><br> <span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Results:</span></b><span style="font-size:11.0pt"> A total of 280 patients were analyzed (mean age: 9.8&plusmn;3.8 years). The highest incidence (58.2%) occurred in children aged 6-12 years (P<0.001). The most common cause was Guillain&ndash;Barr&eacute; syndrome (GBS) (66.4%). Age distribution was significantly correlated with diagnosis (P<0.001), whereas gender showed no correlation in this regard (P=0.385). The mean hospital stay was 12.8&plusmn;9.1 days, being significantly longer in botulism cases (P<0.001). Only 6.4% required special interventions. At discharge, 88.2% achieved complete recovery, 5% showed no improvement, and the mortality rate was 0.7%.</span></span></span></span></span><br> <span style="font-size:10pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt">Conclusion:</span></b> <span style="font-size:11.0pt">GBS remains the predominant non-polio cause of AFP in children. Despite variations in hospital stay, most patients achieved complete recovery with supportive care. The low mortality rate highlights effective management and surveillance. Strengthening laboratory capacity and implementing long-term follow-up are recommended to enhance the sensitivity of AFP surveillance. </span></span></span></td> </tr> </tbody> </table> </div> </div> فلج شل حاد, بوتولیسم, کودکان, سندرم گیلن‌باره, میاستنی گراویس, میلیت عرضی Acute flaccid paralysis, Botulism, Children, Guillain–Barré syndrome, Myasthenia gravis, Transverse myelitis 295 304 http://journal.bums.ac.ir/browse.php?a_code=A-10-3781-1&slc_lang=fa&sid=1 Alireza Abdi علیرضا عبدی alireza.abdi129@gmail.com 8700319475328460051500 8700319475328460051500 No Department of Pediatric Diseases, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran گروه بیماری‌های کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران Mohammd Salavatizadeh محمد صلواتی‌زاده salavatizadeh.m@umsu.ac.ir 8700319475328460051501 8700319475328460051501 Yes Department of Pediatric Diseases, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran گروه بیماری‌های کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران Najmadin Ebrahimi نجم‌الدین ابراهیمی e.najmadin98@gmail.com 8700319475328460051502 0009-0007-5703-9095 No School of Medicine, Urmia University of Medical Sciences, Urmia, Iran دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران