胸腺瘤合并重症肌无力病人的麻醉

Anesthesia Management of Thymoma with Myasthenia Gravis

目的:分析胸腺瘤合并重症肌无力病人的麻醉管理。方法:对28例胸腺瘤合并重症肌无力病人麻醉进行回顾性分析,讨论该种病人的麻醉管理。结果:28例病人麻醉过程相对平稳,25例病人术后短时间拔管,麻醉后复苏室观察1-3 h 后送外科监护室观察1-3 d,3例病人带管直接送外科监护室,24 h之内拔除了气管导管。无一例重症肌无力危象发生。结论:胸腺瘤合并重症肌无力病人需要术前认真准备,术中仔细操作避免大出血,应用平衡麻醉,术后加强监测能够有效防止重症肌无力危象的发生。

Objective： To study the peri-operation anesthesia management of thymoma with myasthenia gravis. Methods：28 patients suffered from thymoma with myasthenia gravis undergoing surgery were enrolled in this study retrospectively, Results： Vital signs of all patients were maintained relatively stable during operation. 25 patients were extubed after operation in a short time and observed for 1-3hrs in PACU（post anesthesia care unit） ,then sent to SICU （surgical intensive care unit） for 1-3days, 3 patients were extubed after sent to SICU within 24 hrs. No patients died and no myasthenia crisis happened. Conclusion：Patients suffered from thymoma with myasthenia gravis undergoing surgery should be well prepared before operation, carefully manipulated avoiding a large amount of loss blood, used with balanced anesthesia during operation and intensively monitored in SICU after operation with continuous neostigmine and methylprednisolone infusion. Myasthenia crisis can be prevented effectively,