Analysis of risk factors of myasthenia crisis after thymectomy in patients with myasthenia gravis
- VernacularTitle:重症肌无力术后发生肌无力危象的危险因素分析
- Author:
LIU Baodong
1
;
ZHANG Yi
1
;
SU Lei
1
;
WANG Ruotian
1
;
LIU Lei
1
;
QIAN Kun
1
;
LI Yuanbo
1
Author Information
1. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P.R. China
- Publication Type:Journal Article
- Keywords:
Myasthenia gravis;
thymectomy;
myasthenic crisis;
mechanical ventilation
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(02):195-198
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors of myasthenia gravis crisis after thymectomy with myasthenia gravis (MG). Methods Sixty-five myasthenia gravis patients who had myasthenia crisis after thymectomy in Xuanwu Hospital, Capital Medical University from June 2006 to June 2019 were retrospectively enrolled, including 31 males and 34 females, aged 15-78 (45.7±17.8) years. The relationship between myasthenia crisis after thymectomy and surgical option, operation time, pathological type, et al. were anylyzed. Results Operation time and pathological type were the predictive factors of postoperative myasthenic crisis. The area under receiver operating characteristic curve (AUC) of MG type (Osserman) was 0.676, the cut-off value wasⅡB type, the sensitivity was 37.5%, the specificity was 90.5%, and the Youden’s index was 0.280. The AUC of thymoma stage (Masaoka) was 0.682, cut-off value was stageⅡ, sensitivity was 62.5%, specificity was 66.7%, and Youden’s index was 0.292. The AUC of blood loss was 0.658, the cut-off value was 90 mL, the sensitivity was 87.5%, the specificity was 69.6%, and the Youden’s index was 0.304. Conclusion Preoperative MG classification, pathological type, operation time and blood loss are the risk factors of postoperative myasthenic crisis. Therefore, adequate preoperative preparation, rapid and careful intraoperative operation and active postoperative management can reduce the occurrence of postoperative myasthenic crisis.
