快速康复外科在重症肌无力外科治疗中的应用  

Clinical appilication of fast track surgery in thymectomy for myasthenia gravis

作　　者：崔新征 张清勇 马文强 赵卫洁 CUI Xinzheng;ZHANG Qingyong;MA Wenqiang;ZHAO Weijie(Henan Provincial People’s Hospital/People’s Hospital of Zhengzhou University/People’s Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院,郑州大学人民医院,河南大学人民医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2020年第5期432-435,共4页Chinese Journal of Practical Nervous Diseases

基　　金：河南省科技攻关项目(编号:172102310278)。

摘　　要：目的探讨快速康复外科在重症肌无力外科治疗中的应用及可行性。方法146例采用快速康复外科围手术期管理方案行胸腔镜手术治疗的重症肌无力患者,男60例,女86例,年龄11~70岁,病程7 d^10 a,采用重症肌无力新的外科临床分型和分期指导选择手术时机。结果所有患者手术后恢复顺利,无术后肌无力危象发生,术后24 h内拔除胸腔引流管和12 h内拔除尿管,术后早期进食和活动。结论快速康复外科理念在重症肌无力微创手术中的应用是安全可行的,结合我科提出的新的重症肌无力外科临床分型和分期指导手术时机的选择,明显降低了术后肌无力危象的发生率,为重症肌无力的围手术期管理提供了一种新的治疗模式。Objective To investigate the appilication and feasibility of fast track surgery(FTS)in thymectomy for myasthenia gravis(MG).Methods 146 cases of the patients with MG received the thymectomy using FTS plan,there were 60 male cases and 86 female cases,with age ranging from 11 to 70 years and chief complaint history ranging from 7 days to 10 years.The selection of surgical opportunity was guided by the new method of clinical typing and staging for MG.Results All patients recovered smoothly without myasthenia crisis.The chest drainage tube was removed within 24 hours and the urinary catheter within 12 hours after operation.The patients early took food and exercise.Conclusion Fast track surgery in the thymectomy for the patients with MG was safe and feasible.The incidence of post-operative myasthenia crisis was significantly reduced by combining with the new method of clinical typing and staging for MG to guide the selection of surgical opportunity,it provides a new treatment model for perioperative management of the patients with MG.

关 键 词：快速康复外科 重症肌无力 胸腔镜 临床分型 临床分期 

分 类 号：R746.1[医药卫生—神经病学与精神病学]