术前用强的松降低术后重症肌无力危象的研究

目的探讨降低胸腺切除术后发生重症肌无力危象的方法。方法将本院40例胸腺瘤合并重症肌无力的患者进行随机分组,分为实验组20例,对照组20例。实验组术前联合溴吡斯的明及强的松个体化治疗2个月左右,对照组术前用溴吡斯的明治疗2个月左右。两组患者均在重症肌无力症状缓解或明显改善后,再行胸腺切除 纵隔脂肪清除术治疗。结果实验组术后出现重症肌无力危象1例(5%),无死亡病例;对照组术后出现重症肌无力危象9例(45%),死亡2例,重症肌无力危象的发生率明显下降,两者有显著意义(P=0.0035<0.05)。结论胸腺瘤合并重症肌无力的患者术前联合用溴吡斯的明及强的松个体化治疗2个月左右,术后重症肌无力危象的发生率显著降低,并发症少,恢复快。

Research of Lowering Incidence of Postoperative Myasthenic Crisis by Preoperative Application of Prednisone

Objective To investigate the methods to lower the incidence of myasthenic crisis after thymectomy.Methods 40 patients with thymoma combined with symptom of myasthenia gravis in our hospital were randomly divided into experimental group and controlled group,each group contains 20 patients.Use both pyridostigmine bromide and prednisone in experimental group,only pyridostigmine bromide in controlled group for about 2 months before thymectomy.Do thymectomy and mediastinal adipectomy after obvious release of symptom of myasthenia gravis in both group.Results One patient got myasthenic crisis after surgery(5%) and no patient died in experimental group.9 patients got myasthenic crisis after surgery(45%) and 2 patients died in controlled group.There was significant difference between two groups(P =0.0035<0.05) .Conclusion Preoperative application of both pyridostigmine bromide and prednisone for about 2 months in patients with thymoma combined with symptom of myasthenia gravis can significantly lower the incidence of postoperative myasthenic crisis,with less complications and better recovery.