胸腺瘤合并重症肌无力术后发生肌无力危象处理体会

目的探讨胸腺瘤切除术后发生重症肌无力危象的原因及治疗方法。方法回顾分析2000年1月至2007年6月我科收治的43例胸腺瘤合并重症肌无力患者中11例发生术后危象的病例资料。结果11例患者中除l例放弃治疗外,其余均治愈出院。术后危象发生率25.5%(11/43),重症肌无力危象主要发生于术后早期。术前准备不充分,手术的创伤,服用抗胆碱酯酶药物剂量不当,感染(尤其是肺部感染)是围术期发生危象的诱因。结论加强围术期管理,可以改善危象的预后,减少发病率和病死率。

Management of myasthenia gravis crisis after resection of thymoma and coexisting thymic tissue

Objective To review the causes and treatment of myasthenia gravis(MG) crisis after resection of thymoma and coexisting thymic tissue.Methods Forty-three patients after resection of thymoma and coexisting thymic tissue between January 2000 and June 2007 were evaluated in a retrospective study.Results Eleven patients with crisis after resection of thymoma and coexisting thymic tissue were recovered except one case quit.The risk factors of MG included the insufficiency preparation before operation,operative injury,the underdosage of anticholinesterase drugs,the postoperative infection of pulmonary.Conclusion Perioperative management substantially improve the prognosis of myasthenia gravis crisis,and decrease significantly the mortality.