重症肌无力致呼吸衰竭机械通气撤机困难6例分析

Respiratory failure and prolonged mechanical ventilation caused by myasthenia gravis:analysis of 6 case

目的:探讨重症肌无力(MG)引起的呼吸衰竭、机械通气撤机困难的原因。方法:回顾性分析北京安贞医院10年间收治的MG引起的呼吸衰竭、撤机困难6例的临床资料,分析其临床特征。结果:患者中男性2例,女性4例,年龄36～78岁,机械通气时间12～72d。经综合治疗后,1例患者成功撤机,3例患者行气管切开,间断使用机械通气治疗, 1例患者携带气管插管、机械通气转院,1例患者拒绝继续机械通气治疗而死亡。结论:解决MG导致的呼吸衰竭撤机困难,关键在于早期明确诊断。撤机困难时针对病因综合治疗可提高撤机成功率。

Objective: Discuss the causes of difficulty in weaning caused by myasthenia gravis and raise awareness. Methods: The clinical data of 6 cases of respiratory failure and difficulty in weaning caused by myasthenia gravis treated by Beijing Anzhen Hospital during the past 10 years were retrospectively analyzed. Results: There were 2 males, 4 females, aged 36-78 years, and mechanical ventilation time 12-72 days. After comprehensive treatment, 1 patient was successfully weaned, 3 patients underwent tracheotomy, intermittent mechanical ventilation, 1 patient with tracheal intubation was transferred, and 1 patient refused to continue mechanical ventilation and died. Conclusions: To solve the difficulty of weaning caused by myasthenia gravis, the key lies in the early diagnosis. When the weaning is difficult, the comprehensive treatment for the cause can improve the success rate of the weaning.