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