重症肌无力患者围手术期呼吸肌训练的效果  

Postoperative effect of respiratory muscle exercise in myasthenia gravis patients with thymectomy

作　　者：宋宣克[1] 张进[1] 董要磊 董梦龙 兰红[1] 黄壮士[1] SONG Xuanke;ZHANG Jin;DONG Yaolei;DONG Menglong;LAN Hong;HUANG Zhuangshi(The Second Affiliated Hospital of Zhengzhou Universsity,Zhengzhou 450052,China)

机构地区：[1]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2022年第1期77-81,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20190308)。

摘　　要：目的观察围手术期呼吸肌训练在重症肌无力术后恢复中的效果。方法选取2016-01—2019-12在郑州大学第二附属医院胸外科行胸腔镜胸腺扩大切除治疗的30例重症肌无力患者为研究对象,2016-01—2017-12手术患者为对照组,术前仅常规术前准备;2018-01—2019-12手术患者为实验组,常规术前准备加围手术期呼吸肌训练。术后监测肺部感染发生率、术后肺不张发生率、胸管拔除时间、重症肌无力危象发生率、术后住院时间。结果对照组术后肺部感染发生率80.0%(12/15),实验组为40.0%(6/15),2组比较差异有统计学意义(P<0.05);对照组术后肺不张发生率33.3%(5/15),实验组为6.7%(1/15),2组比较差异无统计学意义(P>0.05);对照组胸管拔除时间(3.53±1.85)d,实验组为(2.87±0.83)d,2组比较差异无统计学意义(P>0.05);对照组重症肌无力危象发生率13.3%(2/15),实验组为6.7%(1/15),2组比较差异无统计学意义(P>0.05);对照组术后住院时间(9.33±1.32)d,实验组为(7.47±1.19)d,2组比较差异有统计学意义(P<0.05)。结论围手术期呼吸肌训练能降低术后呼吸系统并发症发生率和术后重症肌无力危象发生率,也能缩短胸管拔除平均时间和平均住院时间,促进患者术后康复。Objective To observe the postoperative effect of respiratory muscle exercise during periopera⁃tive period in myasthenia gravis patients with thymectomy.Methods Thirty myasthenia gravis patients,who were underwent video-assisted thoracoscopic extended thymectomy(VATET)in Department of Thoracic Surgery of Second Affiliated Hospital of Zhengzhou University from January 2016 to December 2019,and were divided into experimental group and control group.The myasthenia gravis patients before 2018 who were divided in the control group were underwent routine preoperotive preparation,and the myasthenia gravis patients after 2018 who were di⁃vided in the experimental group were underwent routine preoperotive preparation and respiratory muscle exercise during perioperative period.The incidence of postoperative lung infection,atelectasis incidence,the average time of chest tube remo-val,myasthenic crisis incidence and the average postoperative hospital stay were evaluated and analyzed after thymectomy.Results The incidence of postoperative lung infection was 80.0%(12/15)in the con⁃trol group and 40.0%(6/15)in the experimental group.The difference between the two groups was statistically significant(P<0.05).The incidence of atelectasis was 33.3%(5/15)in the control group and 6.7%(1/15)in the experimental group.The difference between the two groups was not statistically significant(P>0.05).The average time of chest tube removal in the control group was(3.53±1.85)days,and the experimental group was(2.87±0.83)days.The difference between the two groups was not statistically significant(P>0.05).The incidence of myas⁃thenia gravis crisis in the control group was 13.3%(2/15),and the experimental group was 6.7%(1/15).The dif⁃ference between the two groups was not statistically significant(P>0.05).The average postoperative hospital stay in the control group was(9.33±1.32)days,and the experimental group was(7.47±1.19)days,the difference be⁃tween the two groups was statistically significant(P<0.05).Conclusion Perioperative

关 键 词：重症肌无力 重症肌无力危象 呼吸肌训练 围手术期 术后并发症 

分 类 号：R746.1[医药卫生—神经病学与精神病学]