重症肌无力危象多学科协作的华山经验  

The Huashan Experience of Multidisciplinary Collaboration in Myasthenia Crisis

作　　者：罗苏珊 奚才华 杨磊 郑建铭 王苑 许雅芳 黄清昱 王卫宁 赵重波 LUO Su-shan;XI Cai-hua;YANG Lei;ZHENG Jian-ming;WANG Yuan;XU Ya-fang;HUANG Qing-yu;WANG Weining;ZHAO Chong-bo(Department of Neurology,Huashan Hospital,Fudan University,Shanghai 200040,China;Intensive Care Unit Huashan,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Infectious Disease,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Blood Transfusion,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Cardiology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Rehabilitation,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院神经内科,上海200040 [2]复旦大学附属华山医院重症医学科,上海200040 [3]复旦大学附属华山医院感染科,上海200040 [4]复旦大学附属华山医院输血科,上海200040 [5]复旦大学附属华山医院心内科,上海200040 [6]复旦大学附属华山医院康复医学科,上海200040

出　　处：《中国临床神经科学》2023年第5期550-557,共8页Chinese Journal of Clinical Neurosciences

基　　金：国家重点研发计划重症肌无力中医诊疗规律系统化研究(编号2022YFC3501303);国家自然科学基金面上项目(编号:82071410);上海市“脑与类脑智能”市级重大科技专项资助(编号:2018SHZDZX01)和张江实验室;上海市医企融合创新成果转化专项课题(编号:SHDC2023CRD007)。

摘　　要：重症肌无力危象(MC)是重症肌无力(MG)患者出现呼吸衰竭、需要机械呼吸支持的最危急状态,具有较高的在院病死率和较长的ICU住院时间。在神经重症监护室内建立“危象单元”,由神经内科、重症医学科、感染科、输血科、心内科、护理部和康复医学科等多学科团队组成医疗综合体,从气道管理、快速疗法、重症肺炎的监测和预防、身心护理及综合康复等方面,为MC患者提供高效的个体化治疗。文中介绍复旦大学附属华山医院的单中心经验,以探讨MC患者管理的多学科诊疗协作模式。Myasthenia crisis(MC)is a life-threatening state of patients with myasthenia gravis(MG)who develop respiratory failure with mechanical ventilation demands.Patients with MC presented a high in-hospital mortality as well as a long ICU stay.The establishment of the MC Unit in NICU(neurological intensive care unit)with a multidisciplinary effort from neurology,critical care,infectious disease,blood transfusion department,cardiology,nursing,and rehabilitation,should shed new light on the path to provide more comprehensive and individualized service for patients with MC.The single-center experience in the multidisciplinary treatment of MC was briefly introduced to explore the future directions of patient-centered clinical management.This white paper mainly refers to drug approvals and clinical practices in Europe,resulting in limited applicability in China.However,the guidelines can still provide a reference for the development of guidelines in China and offer guidance for clinical practice to some extent.The some contents of this white paper were introduced and interpreted.

关 键 词：重症肌无力 重症肌无力危象 呼吸支持 重症监护室 多学科协作 危象单元 

分 类 号：R746.1[医药卫生—神经病学与精神病学]