重症肌无力危象抢救分析

ANALYSIS IN TREATMENT OF MYASTHENIC CRISIS

目的：复习重症肌无力（ＭＧ）危象抢救的体会及经验。方法：对１０年间抢救２３例ＭＧ危象的临床特点、救治方法、并发症及死亡率进行总结分析。结果：平均发病年龄约３７岁，自ＭＧ发病至发生危象约２年，上呼吸道感染为最常见诱因。延髓肌麻痹需高度重视。应用呼吸机辅助呼吸平均为２周。并发症以肺炎及肺部感染为常见，激素治疗是主要手段之一。所有病人应用抗生素预防或治疗感染。死亡率为２１．７４％。结论：及时插管甚至预防性气管切开，应用呼吸机，加强呼吸道管理，预防和治疗肺部感染，可改善危象的预后，明显降低死亡率。

Objective: To review the experience in treatment and rescue of myasthenic crisis Methods: To analyze the clinical feature,treatment and rescuse,complications and mortality in 23 patients with MG crisis over a period of 10 years Results: Median age of onset of the first crisis was 37,and the median interval from onset of symptoms to the first crisis was 2 yearsUpper respiratory infection was the most common precipitation factorWeakness of oropharyngeal muscles should arouse more attentionThe time for mechanical ventilation was two weeksPneumonia and pulmonary infection were common complicationsTreatment with corticosteroids was one of the main methodsAntibiotics were used to prevent and treat infection in all patientsThe mortality rate was 2174% Conclusion: Once there is prompt application of mechanical ventilation,improvement of respiratory care,preventment and treatment of pulmonary infections,there will be improvemeat for the outcomes in the future and decline the mortality rate\=