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20例重症肌无力术后危象的处理 被引量:13

Postoperative management of crisis of myastheniagravis :analysis of 20 patients
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摘要 1983年6月至1992年3月采用胸腺-胸腺瘤切除治疗重症肌无力95例。(isserman氏分型Ⅲ和Ⅳ型12例,占60%。5例作剖胸切口,余均为胸骨正中切口。全组合并胸腺瘤17例,其中20例术后发生危象,除1例胆碱能危象外,余均为肌无力危象。危象抢救成功率95%,手术死亡率5%(1/20)。12例存活2.5~10年以上,后期死亡7例。作者认为危象发生后立即施行气管切开,应用呼吸机,调整药物剂量,控制呼吸道感染,加强营养支持是降低死亡率,确保抢救成功的关键。 AbstractFrom June 1983 to March 1992,95 patients withof myasthenia gravis were treated with thyroma-thy-roidectomy. Among them 90 patients were takenmidsternotomy, and others stdndard lateral thoracoto-my. All the patients had postoperative crisis of mya-thenia except one who had a cholingergic crisis.12 pa-tients(60%)belonged to type Ⅲ and Ⅳ According tothe Osserman's classification. The pathologicalfindings showed that 17 patients had combined thyro-ma. The management for crisis was satisfactoriy with asuccess rate of 95%.The mortality rate was 5%(1/20)in early postoperative stage and 35%(7/20) in lat-er stage,respectively. 12 patients survived for 2.5 to10 years. Tracheotomy,mechanical ventilation adjust-Tnent, control of infection of the respiratory tract,andnourishment supporta are the key meassures for successful postoperative therapy and decrecse of mortali-ty .
出处 《中华外科杂志》 CAS CSCD 北大核心 1995年第4期234-235,共2页 Chinese Journal of Surgery
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参考文献5

  • 1曾涟乾,中华胸心血管外科杂志,1991年,7卷,99页
  • 2王律,中华外科杂志,1989年,27卷,284页
  • 3罗洁庵,中华肿瘤杂志,1984年,6卷,296页
  • 4张振馨,中华内科杂志,1982年,21卷,273页
  • 5王一山,中华外科杂志,1961年,9卷,823页

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