Abstract：
OBJECTIVE: To study the influencing factors of myasthenic crisis in non-thymoma myasthenia gravis (MG) patients during perioperative period.
METHODS: We retrospectively analyzed a total of 387 non-thymoma MG patients who underwent extended thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from February 2011 to December 2021, recorded ASA score, Osserman classification, preoperative course, pyridostigmine dosage, operation method, operation time, and intraoperative blood loss, then analyzed the factors associated with postoperative myasthenic crisis by univariate and multivariate logistic regression.
RESULTS: Osserman classification IIB + III + IV (P < 0.001), history of myasthenic crisis (P = 0.013), pyridostigmine dosage greater than 240 (P < 0.001), ASA score 2 and 3 (P = 0.001) are independent risk factors for myasthenic crisis.
CONCLUSIONS: Patients with poor Osserman classification, history of myasthenic crisis before surgery, larger preoperative dosage of pyridostigmine, and higher ASA scores should be highly alert to the occurrence of postoperative myasthenic crisis.
METHODS: We retrospectively analyzed a total of 387 non-thymoma MG patients who underwent extended thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from February 2011 to December 2021, recorded ASA score, Osserman classification, preoperative course, pyridostigmine dosage, operation method, operation time, and intraoperative blood loss, then analyzed the factors associated with postoperative myasthenic crisis by univariate and multivariate logistic regression.
RESULTS: Osserman classification IIB + III + IV (P < 0.001), history of myasthenic crisis (P = 0.013), pyridostigmine dosage greater than 240 (P < 0.001), ASA score 2 and 3 (P = 0.001) are independent risk factors for myasthenic crisis.
CONCLUSIONS: Patients with poor Osserman classification, history of myasthenic crisis before surgery, larger preoperative dosage of pyridostigmine, and higher ASA scores should be highly alert to the occurrence of postoperative myasthenic crisis.
摘要：
目的：探讨非胸腺瘤型重症肌无力(MG)患者围手术期发生肌无力危象的影响因素。
方法：回顾性分析2011年2月至2021年12月在北京医院胸外科行扩大胸腺瘤切除术的387例非胸腺瘤MG患者，记录ASA评分，Osserman分类,术前课程，吡啶斯的明剂量,操作方法,操作时间,术中失血,然后通过单因素和多因素logistic回归分析术后肌无力危象的相关因素。
结果：Osserman分类IIBIIIIV（P<0.001），肌无力危象史（P=0.013），吡啶斯的明剂量大于240（P<0.001），ASA评分2和3分(P=0.001)是肌无力危象发生的独立危险因素。
结论：Osserman分类较差的患者，术前肌无力危象史，术前剂量较大的吡啶斯的明，较高的ASA评分应高度警惕术后肌无力危象的发生。
方法：回顾性分析2011年2月至2021年12月在北京医院胸外科行扩大胸腺瘤切除术的387例非胸腺瘤MG患者，记录ASA评分，Osserman分类,术前课程，吡啶斯的明剂量,操作方法,操作时间,术中失血,然后通过单因素和多因素logistic回归分析术后肌无力危象的相关因素。
结果：Osserman分类IIBIIIIV（P<0.001），肌无力危象史（P=0.013），吡啶斯的明剂量大于240（P<0.001），ASA评分2和3分(P=0.001)是肌无力危象发生的独立危险因素。
结论：Osserman分类较差的患者，术前肌无力危象史，术前剂量较大的吡啶斯的明，较高的ASA评分应高度警惕术后肌无力危象的发生。
