重症肌无力症行胸腺切除术后危象的防治（附23例临床资料分析）

Prevention and Treatment of Myasthenia Gravis Crisis after Thymectomy

本文报告了重症肌无力症行胸腺切除术后危象２３例，占我科手术治疗１０７例重症肌无力病例的２１．５％，因危象死亡１例（４．３％）。通过对临床资料进行分析，作者认为，重症肌无力症行胸腺切除术后危象多数可以预测，发生危象与病人重症肌无力临床类型，术前服用抗胆碱酯酶药物剂量，是否合并胸腺瘤，术前曾发生危象以及肺通气功能障碍等因素有关。对于术前预测术后可能发生危象者，可于术毕行预防性气管切开，合理调整抗胆碱酯酶药物用药剂量，加强控制肺部感染等综合性防治措施。

This paper presents the experience of 23 patients with Myathenra Gravis(MG)crisis after thymectomy, which account for 21.5% in 107 cases of MG underwent surgical treatment.one case died of MG crisis(4.3%),The results of this study showed that many postoperative MG crises could be predicated before the operation.The factors contributing to the crisis included the clinical classfication of MG;the dosage of anticholinesteras drugs which the patient taked in;associated with thymoma or not;with MG crisis before operation; and the conditions of the lung function.If that MG crisis was predicated to be occured after thyectomy.The following preventive measure should be takes, preventive tracheotomy to maintain the atency of respiratoy trace and good ventilation;adjusting the dose of anticholinesteras drugs and the prevention and treatment of pulmonary infection.