摘要
目的分析胸腺瘤切除术后的重症肌无力发生情况及影响因素,旨在为临床预防术后重症肌无力提供参考依据。方法选取金华市中心医院2019年3月一2020年3月收治的92例胸腺瘤切除术患者,观察并记录术后重症肌无力的发生情况,统计发生率,并根据术后是否发生重症肌无力将患者分为重症肌无力组(A组,11例)与未发生重症肌无力者(B组,81例),收集2组患者的一般资料,整理临床资料,对比2组一般资料与临床资料的差异性,应用多因素logistic回归分析法分析术后发生重症肌无力的危险因素。结果92例患者术后发生重症肌无力11例,发生率为12.0%;2组患者的术前病程、合并免疫疾病、手术路径、合并前纵隔脂肪清扫术、术后肺部感染、术后放化疗情况对比,差异有统计学意义(均P<0.05);多因素logistic回归分析结果显示,术前病程(>12个月)、合并免疫疾病、手术路径(开胸)、术后肺部感染是术后发生重症肌无力的危险因素,合并前纵隔脂肪清扫术、术后放化疗是其保护因素。结论胸腺瘤切除术后的重症肌无力发生率较高,影响因素也较多,常见如术前病程长、合并免疫疾病、开胸手术、术后肺部感染等,因此行胸腺瘤切除术时应针对患者的危险因素采取对症处理措施,以降低重症肌无力发生率,提高手术治疗效果。
Objective To analyze the incidence and infuencing factors of myasthenia gravis after thymectomy,in order to provide reference for clinical prevention of myasthenia gravis.Methods Ninety-two patients with thymectomy in our hospital from March 2019 to March 2020 were selected to observe and record the incidence of myasthenia gravis after op-eration.The patients were divided into group A and group B according to whether myasthenia gravis occurred after opera-tion.The general data of the two groups were ollcted by qucstionnaire survey,the clinical data were sorted out,and the general data and clinical data of the two groups were compared.The risk factors of myasthenia gravis were analyzed by lo-gistic regression analysis.Results There were 11 cases of myasthenia gravis(12.0%)after operation in 92 patients.The course of disease,combined immune disease,operation route,combined anterior mediastinal fat dissection,postop-erative pulmonary infection,postoperative radiotherapy and chemotherapy were compared between the two groups,and the difference was statistically signifieant(all P<0.05).The results of multivariale logistic regression analysis showed that the course of disease(>12 months),combined immune disease,surgical route(open chest)and postoperative pulmo-nary infection were the risk factors of myasthenia gravis,and the combined anterior mediastinal fat dissection,postopera-tive radiotherapy and chemotherapy were the protective factors.Conclusion The incidence of myasthenia gravis after thymectomy is relatively high,and there are many influencing factors,such as long course of disease,combined with im-mune diseases,thoracotomy,postoperative pulmonary infection,etc.Therefore,we should take symptomatic treatment measures according to the risk factors of patlents during thymectomy 1t0 reduce the incidence of myasthenia gravis and im-prove the ffect of surgery.
作者
许博
王叶萍
陈献国
张晓玲
XU Bo;WANG Ye-ping;CHEN Xian-guo;ZHANG Xiao-ling(Cardiothoracic Surgery,Jinhua Central Hospital,Jinhua,Zhejiang 312000,China)
出处
《中华全科医学》
2020年第10期1678-1681,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2017KY686)
金华市科学技术局重点课题(2020-3-040)。
