發(fā)布時間：2018-03-25 11:30

  本文選題：重癥肌無力　切入點：胸腺切除　出處：《臨床神經(jīng)病學雜志》2017年01期

【摘要】：目的探討重癥肌無力(MG)患者胸腺切除術(shù)圍手術(shù)期并發(fā)肌無力危象的危險因素。方法收集63例MG患者的臨床資料,按照圍手術(shù)期是否發(fā)生肌無力危象,分為發(fā)生危象組和未發(fā)生危象組,分析肌無力危象的危險因素。結(jié)果本組發(fā)生肌無力危象12例(19.0%)(發(fā)生危象組),未發(fā)生肌無力危象51例(81.0%)(未發(fā)生危象組)。與發(fā)生危象組比較,未發(fā)生危象組Osserman分型、術(shù)式、手術(shù)時間、術(shù)中出血量及病理類型差異有統(tǒng)計學意義(P0.05~0.01)。多變量Logistic回歸分析顯示,Osserman分型(Ⅱb+Ⅲ型)、手術(shù)時間(3 h)、術(shù)中出血量(100 ml)以及病理類型(侵襲性胸腺瘤)是肌無力危象的獨立危險因素(OR=55.257,95%CI:7.953~383.909,P=0.000;OR=105.243,95%CI:8.570~1292.357,P=0.000;OR=14.008,95%CI:2.597~75.559,P=0.002;OR=18.552,95%CI:4.368~78.789,P=0.000)。結(jié)論 Osserman分型Ⅱb+Ⅲ型、手術(shù)時間3 h、術(shù)中出血量100 ml以及侵襲性胸腺瘤是胸腺切除術(shù)圍手術(shù)期并發(fā)肌無力危象的獨立危險因素。充分的術(shù)前評估準備、減少術(shù)中出血及縮短手術(shù)時間有助減少肌無力危象發(fā)生。
[Abstract]:Objective to investigate the risk factors of perioperative myasthenia crisis in patients with myasthenia gravis (MG). Methods the clinical data of 63 patients with MG were collected. The risk factors of myasthenia crisis were analyzed. Results there were 12 cases of myasthenia crisis in this group, 51 cases had no myasthenia crisis group and 51 cases had no myasthenia crisis group. In the group without crisis, Osserman classification, operation method, operation time, The results of multivariate Logistic regression analysis showed that Osserman type (鈪，

本文編號：1662929