重症肌无力病人胸腺切除术后危象发生的多因素分析

Factors contributing to myasthenic crisis after thymectomy-a multivariate analysis study

目的 探讨重症肌无力（MG）病人胸腺切除术后危象发生的危险因素.方法 回顾性分析1995年7月至2009年12月确诊为MG者进行胸腺扩大切除术84例的临床资料.对性别、年龄、术前危象史、Ossermen分型、术前是否使用激素和（或）抗胆碱酯酶药物、手术方式、手术时间、胸腺瘤、病？ 理类型、输血和病程、术后肺部感染进行多因素Logistic回归分析.结果 术后出现MG危象24例（28.6%）.危象的发生与术前危象史、Ossermen分型、手术方式、手术时间有关.结论 有术前危象史、OssermenⅡb型及以上、传统手术方式和手术时间长均是易发生术后危象的独立危险因素.

Objective To evaluate the risk factors of myasthenic crisis（MC） after thymectomy for myasthenia gravis （MG） Methods A retrospective study was conducted in 84 patients with MG from July 1995 to December 2009. The following factors were evaluated： sex, age, history of preoperative myasthenic crisis, Osssrmen classification, use steroid hormones and anticholinesterase drugs before operation, operation methods, operation time, thymoma, pathology, transfusion, course of disease, postopertive lung infection,etc. Multivariate logistic regrossion analysis was used to find the predictors of postoperative myasthenic crisis. Results Twenty-four patients（28.6%） developed myasthenic crisis after thymectomy. Statistics showed that history of preoperative myasthenic crisis, Ossermen classification, operation methods, operation time were related to postoperative myasthenic crisis. Conclusion Preoperative myastheric crisis, Ossermen classification≥I b, traditional operation methods, long opertion time are the independent risk factors for myasthenic crisis after thymectomy.