重症肌无力病人胸腺切除围术期的处理

The Perioperative Care and Management of Thymectomy in Patients with Myasthenia Gravis

１９７８年１月到１９９４年１０月，采用胸腺切除术治疗重症肌无力２３例。１９８６年以前，围手术期处理不当，７例病人术后发生肌无力危象５例，胆碱能危象３例，３例因危象死亡。１９８５年以后，加强改进围手术期处理，１６例病人术后发生肌无力危象３例，胆碱能危象１例，无手术死亡。本文对术前准备、术后处理要点，以及气管切开、呼吸机治疗在防治术后肌无力、胆碱能危象中的作用，进行了讨论。

From January 1978 to October 1994,23 patients with Myasthenia Gravis(MG)underwent thymectomy. Befor 1985,5 patients complicated with Myasthenia Geavis Crisis,3 cases with Cholinergic Crisis because of imperfective perioperative management.3 cases died of MG. After 1985,we improved the perioperative management,3 cases of MG and 1 case of Cholinergic Crisis occured,and no one died.In this paper,The key poits of perioperative preperation,postoperative care and management,early tracheostomy and ventilation-therapy in the prevention and treatment of Myasthenia Gravis Crisis and Cholinergic Crisis after operation have been discussed.