| 摘要: |
| ［摘要］ 目的 分析全身型重症肌无力（MG）患者胸腺切除术后肌无力危象（POMC）的影响因素。方法 回顾性分析2018年1月至2022年6月于首都医科大学宣武医院胸外科接受胸腺切除术的116例全身型MG患者的临床资料，根据术后是否出现POMC分为POMC组38例和非POMC组78例。对其临床特点进行单因素和多因素分析，确定POMC的影响因素。结果 POMC组的机械通气时间、住ICU时间显著长于非POMC组（P<0.001）。POMC组和非POMC组在改良Osserman分型、合并胸腺瘤、手术方式、用力肺活量（FVC）、第一秒用力呼气容积（FEV1）以及血清白蛋白与球蛋白比值（AGR）等方面比较差异均有统计学意义（P<0.05）。多因素logistic回归分析结果显示，Osserman分型、FVC、FEV1以及AGR是POMC发生的影响因素（P<0.05）。结论 术前Osserman分型、FVC、FEV1以及AGR是全身型MG患者发生POMC的影响因素，可为临床工作提供参考。 |
| 关键词: 重症肌无力 术后肌无力危象 胸腺切除术 肺功能 白蛋白与球蛋白比值 |
| DOI：10.3969/j.issn.1674-3806.2023.06.05 |
| 分类号:R 746.1 |
| 基金项目: |
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| Analysis of the influencing factors of myasthenic crisis after thymectomy in patients with generalized myasthenia gravis |
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LI Yuan-bo, ZHANG Yi, SU Lei, et al.
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Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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| Abstract: |
| ［Abstract］ Objective To analyse the influencing factors of postoperative myasthenic crisis(POMC) in generalized myasthenia gravis(MG) patients. Methods The clinical data of 116 patients with generalized MG who underwent thymectomy in the Department of Thoracic Surgery of Xuanwu Hospital, Capital Medical University from January 2018 to June 2022 were retrospectively analyzed. The patients were divided into POMC group(38 cases) and non-POMC group(78 cases) according to whether they had developed POMC. Univariate and multivariate regression analyses were performed to determine the influencing factors of POMC. Results The mechanical ventilation duration and intensive care unit(ICU) stay in the POMC group were significantly longer than those in the non-POMC group(P<0.001). There were statistically significant differences between the POMC group and non-POMC group in modified Osserman classification, whether thymoma was complicated with, operation method, forced vital capacity(FVC), forced expiratory volume in the first second(FEV1) and albumin to globulin ratio(AGR)(P<0.05). The results of multivariate logistic regression analysis showed that Osserman classification, FVC, FEV1 and AGR were the influencing factors for occurrence of POMC(P<0.05). Conclusion Preoperative Osserman classification, FVC, FEV1 and AGR are the influencing factors for the occurrence of POMC in the generalized MG patients, which can provide reference for clinical practice. |
| Key words: Myasthenia gravis Postoperative myasthenic crisis Thymectomy Lung function Albumin to globulin ratio |
