摘要
目的：探讨重症肌无力（ＭＧ）患者胸腺切除术的术前准备注意事项。方法：分析５５例患者术前准备经过，包括抗胆碱酯酶药和皮质类固醇激素的应用，补钾及麻醉前用药等。比较了术前使用激素（激素组，ｎ＝２０）和不用者（非激素组，ｎ＝３５）术后呼吸恢复经过（肌无力危象的发生和因危象或呼吸恢复差而需呼吸支持）。结果：本组患者术前４０％存在低钾；术前应用哌替啶不会造成呼吸抑制；术前使用激素与否对术后呼吸恢复无影响（Ｐ＞００５）。结论：ＭＧ患者易出现低钾，应予重视；哌替啶１ｍｇ·ｋｇ－１肌注作为经过充分准备的ＭＧ患者术前用药是安全的；本组病例中术前使用皮质类固醇激素并未能改善术后呼吸恢复经过。
Objective: To find the key points of preoperative preparation for myasthenia gravis (MG)patients undergoing thymectomy. Methods: To review the 55 MG patients′ preoperative preparation, including administration of cholinesterase inhibitor(CHEI), corticosteroid, potassium and preanesthetic medication. Compared the respiratory recovery process (incidence of respiratory support and myasthenic crisis respectively) between the patients received preoperative corticosteroid therapy (Group C,n=20) or not (Group NC,n=35). Results: In this series we observed, 40% of the patients were hypopotassemia preoperatively. Pethidine used as preanesthetic medication would not cause respiratory depression. There is no statistical difference between Group C and Group NC about the incidence of postoperative respiratory support and myasthenic crisis(P>0 05). Conclusions: Hypopotassemia should be carefully corrected preoperatively because of the high incidence(40%) of hypopotassemia in MG patients. Pethidine 1 mg·kg -1 administered intramuscularly is a safe preanesthetic medication for MG patients and preoperative corticosteroid could not improve postoperative respiratory recovery process in this series.
出处
《中山医科大学学报》
CSCD
1998年第4期303-306,共4页
Academic Journal of Sun Yat-sen University of Medical Sciences
关键词
重症肌无力
胸腺切除
术前用药
myasthenia gravis/surgery
thymectomy/methods
premedication
