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重症肌无力患者围手术期管理
引用本文:张清勇,杨鲲鹏,苏彦河,张水兰,张斌,尹年太,张灿宇,吉庆春,黄壮士,吕玉珍,黄文玲,孙淑云,兰红,王丽晓. 重症肌无力患者围手术期管理[J]. 郑州大学学报(医学版), 2005, 40(1): 11-13
作者姓名:张清勇  杨鲲鹏  苏彦河  张水兰  张斌  尹年太  张灿宇  吉庆春  黄壮士  吕玉珍  黄文玲  孙淑云  兰红  王丽晓
作者单位:1. 郑州大学第二附属医院普胸外科,郑州,450014;郑州大学生物医学工程研究所,郑州,450052
2. 郑州大学第二附属医院普胸外科,郑州,450014
基金项目:国家自然科学基金资助项目 39970264,河南省 2002年度杰出青年科学基金资助项目 0212000100
摘    要:目的:对胸腺切除术治疗重症肌无力患者的围手术期管理进行总结。方法:365例重症肌无力患者采用经前胸第二肋间横断胸骨小切口行胸腺切除术。术前口服皮质类固醇、胆碱酯酶抑制剂改善肌无力症状,处理并发症;术中彻底清扫胸腺及前纵隔脂肪;术后继续应用胆碱酯酶抑制剂,加强呼吸道管理。结果:329例患者安全渡过围手术期;36例发生术后危象,其中治愈28例,自动出院5例,死亡3例。结论:规范合理的围手术期处理可保证MG手术安全性,提高手术疗效,降低病死率。

关 键 词:重症肌无力 胸腺切除术 围手术期管理
修稿时间:2004-04-20

Perioperative management of patients with myasthenia gravis
ZHANG Qingyong ,),YANG Kunpeng ),SU Yanhe ),ZHANG Shuilan ),ZHANG bin ),YIN Niantai ),ZHANG Canyu ),JI Qingchun ),HUANG Zhuangshi ),LU Yuzhen ),HUANG Wenling ),SUN Shuyun ),LAN Hong ),WANG Lixiao ) ). Perioperative management of patients with myasthenia gravis[J]. Journal of Zhengzhou University: Med Sci, 2005, 40(1): 11-13
Authors:ZHANG Qingyong   )  YANG Kunpeng )  SU Yanhe )  ZHANG Shuilan )  ZHANG bin )  YIN Niantai )  ZHANG Canyu )  JI Qingchun )  HUANG Zhuangshi )  LU Yuzhen )  HUANG Wenling )  SUN Shuyun )  LAN Hong )  WANG Lixiao ) )
Affiliation:ZHANG Qingyong 1,2),YANG Kunpeng 1),SU Yanhe 1),ZHANG Shuilan 1),ZHANG bin 1),YIN Niantai 1),ZHANG Canyu 1),JI Qingchun 1),HUANG Zhuangshi 1),LU Yuzhen 1),HUANG Wenling 1),SUN Shuyun 1),LAN Hong 1),WANG Lixiao 1) 1)Department of Thoracic Surgery,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014 2)Biological Medicine Institute of Zhengzhou University,Zhengzhou 450052
Abstract:Aim: To summerize the perioperative management of thymectomy for myasthenia gravis(MG).Methods: A total of 365 cases of MG treated with thymectomy by sternum transverse in second spatium intercostale incision were orally administrated corticosteroids before the surgery, and cholinesterase inhibitor before and after the surgery.Results: A total of 329 patients survived the perioperative period.Thirty six developed myasthenic crisis, among whom 28 were cured, 5 were out of the hospital, and 3 died.Conclusion: Standardized perioperative management may ensure the safety of thymectomy.
Keywords:myasthenia gravis  thymectomy  perioperative management
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