重症肌无力患者胸腺切除术围手术期重症肌无力危象的危险因素分析

发布时间：2018-03-25 11:30

  本文选题：重症肌无力　切入点：胸腺切除　出处：《临床神经病学杂志》2017年01期

【摘要】：目的探讨重症肌无力(MG)患者胸腺切除术围手术期并发肌无力危象的危险因素。方法收集63例MG患者的临床资料,按照围手术期是否发生肌无力危象,分为发生危象组和未发生危象组,分析肌无力危象的危险因素。结果本组发生肌无力危象12例(19.0%)(发生危象组),未发生肌无力危象51例(81.0%)(未发生危象组)。与发生危象组比较,未发生危象组Osserman分型、术式、手术时间、术中出血量及病理类型差异有统计学意义(P0.05~0.01)。多变量Logistic回归分析显示,Osserman分型(Ⅱb+Ⅲ型)、手术时间(3 h)、术中出血量(100 ml)以及病理类型(侵袭性胸腺瘤)是肌无力危象的独立危险因素(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)。结论 Osserman分型Ⅱb+Ⅲ型、手术时间3 h、术中出血量100 ml以及侵袭性胸腺瘤是胸腺切除术围手术期并发肌无力危象的独立危险因素。充分的术前评估准备、减少术中出血及缩短手术时间有助减少肌无力危象发生。
[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，

本文编号：1662929