Predictors of extubation outcomes following myasthenic crisis.
Predictors of extubation outcomes following myasthenic crisis.
复制标题
肌无力危象后拔管结果的预测因素
DOI：
10.1177/0300060516669893
复制
发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Cheng C
中科院分区：
文献类型：
--
作者：
Liu Z;Yao S;Zhou Q;Deng Z;Zou J;Feng H;Zhu H;Cheng C
肌无力危象（MC）被认为是重症肌无力患者最严重的不良事件。本回顾性研究旨在评估MC患者临床结局的预测因素。回顾性分析了2002年至2014年33例患者（19例女性，14例男性）的76次MC发作的病历。MC期间早期拔管（≤7天）和延长通气（>15天）用于评估患者结局。在33例患者中，24例（72.7%）乙酰胆碱受体抗体检测结果阳性，20例（60.6%）在随访期间（中位数83.6个月，范围1.5-177个月）复发MC发作（≥2次发作）。MC期间血浆置换与早期拔管显著相关。男性、年龄较大（>50岁）、肺不张和呼吸机相关性肺炎显著导致通气时间延长。在22例接受胸腺切除术的患者中，手术后MC发作之间的持续时间和MC发作的平均次数均显著减少。发现MC发作期间的血浆置换对早期拔管很重要;老年患者和肺不张或呼吸机相关性肺炎患者更容易受到长时间通气的影响。胸腺切除术可能有助于防止MC复发。
Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. The medical charts of 33 patients (19 women, 14 men) with 76 MC attacks from 2002 to 2014 were retrospectively reviewed. Early extubation (≤7 days) and prolonged ventilation (>15 days) during the MC were used to assess patient outcomes. Among the 33 patients, 24 (72.7%) had positive acetylcholine receptor antibody test results and 20 (60.6%) experienced recurrent MC attacks (≥2 episodes) during follow-up (median 83.6 months, range 1.5–177 months). Plasma exchange during an MC was significantly associated with early extubation. Male sex, older age (>50 years), atelectasis, and ventilator-associated pneumonia significantly contributed to prolonged ventilation. In 22 patients who underwent thymectomy, both the duration between MC attacks and the mean number of MC attacks were significantly reduced after surgery. Plasma exchange during MC attacks was found to be important for early extubation; older patients and those with atelectasis or ventilator-associated pneumonia were more vulnerable to prolonged ventilation. Thymectomy may be useful to prevent recurrence of MC.
登录
查看更多内容
影响因子：
2
作者：
Nam, Tai-Seung;Lee, Seung-Han;Lee, Min-Cheol
通讯作者：
Lee, Min-Cheol
影响因子：
2.6
作者：
El Hammoumi, Massine;Arsalane, Adil;Kabiri, El Hassane
通讯作者：
Kabiri, El Hassane
影响因子：
2
作者：
Kirmani, Jawad F.;Yahia, Abutaher M.;Qureshi, Adnan I.
通讯作者：
Qureshi, Adnan I.
影响因子：
2.7
作者：
Juel, VC
通讯作者：
Juel, VC
影响因子：
2.6
作者：
Soleimani A;Moayyeri A;Akhondzadeh S;Sadatsafavi M;Tavakoli Shalmani H;Soltanzadeh A
通讯作者：
Soltanzadeh A