重症肌无力患者麻醉选择的探讨

目的探讨重症肌无力（MG）患者胸腺切除术的麻醉方法。方法 36例MG病人诱导给予咪唑安定、芬太尼、丙泊酚和琥珀胆碱,经鼻腔气管插管。麻醉维持前期7例采用阿曲库铵和异氟醚;后期29例采用N2O和异氟醚。比较两者的延迟拔管率。结果麻醉维持前期采用阿曲库铵和异氟醚的7例患者,术后均带气管导管回监护室,其中4例行呼吸支持36 h,3例行呼吸支持2～7 d,延迟拔管率为100%。后期采用N2O和异氟醚的29例患者中24例在手术室内成功拔管,术后无需呼吸支持,拔管率为82.8%;5例术后需行呼吸支持,时间12 h～7 d,延迟拔管率为17.2%。两者术后延迟拔管率比较有统计学意义（P〈0.05）。结论 MG患者行胸腺切除术,术中吸入N2O＋O2和异氟醚是一种安全的麻醉方法。

EXPLORATION ON ANESTHESIA CHOICES FOR PATIENTS WITH MYASTHENIA GRAVIS

Objective To explore the anesthesia choice for the thymusectomy of patients with myasthenia gravis(MG).Methods 36 MG patients were chosen,7 cases of tem formed the protophase group(group A),and others formed the later group(group B).Imidazolam,fentanyl,propofol and succinylcholine were administered for inducement with nasal endotracheal intubation.Atracurium and isoflurane were adopted in group A for the anesthesia maintenance.nitrous oxide and isoflurane were adopted during the anesthesia maintenance in gr...