Exploration on risk factors of perioperative tracheostomy in patients with myasthenia gravis having undergone thymectomy
- VernacularTitle:重症肌无力围手术期气管切开的危险因素探讨
- Author:
Yunping ZHAO
- Publication Type:Journal Article
- From:Journal of Third Military Medical University
2001;23(2):235-236
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors and indications for perioperative tracheostomy in patients with myasthenia gravis. Methods A total of 174 patients with myasthenia gravis undergoing thymectomy were reviewed retrospectively between April 1980 and August 1999. Perioperative tracheostomy was performed on 44(25.3%) cases. Myasthenic or cholinergic crisis happened in 38 cases (21.8%). The relationship of the crisis incidence and Osserman classification, state of illness, present of thymoma, preoperative pulmoary function and the dose of anticholinergic agents given preoperatively were analyzed. At the same time the indications of perioperative tracheostomy were discussed. Results The highest incidence of myasthenic or cholinergic crisis and perioperative tracheostomy were found in cases with long history of the disease, high dose of anticholinergic agents administration, Osserman classification over stageⅡb, with infiltrated thymoma, and preoperative pulmoary function impairment. Conclusion Perioperative tracheostomy and artificial ventilation are most important approaches when myasthenic or cholinergic crisis after thymectomy appeared. But the indications for postoperative prophylactic tracheostomy and artificial ventilation must be strictly selected.
