单纯胸腺瘤术后早期新发重症肌无力危象1例并文献复习

doi:10.3969/j.issn.1009-976X.2025.04.006

摘要/Abstract

摘要： 目的探讨胸腺瘤手术后早期新发重症肌无力危象（MC）的危险因素及防治措施。方法回顾性分析河北省沧州中西医结合医院1例单纯胸腺瘤术后早期新发MC的临床病理资料,并复习相关文献。结果青年患者,因纵隔肿物手术治疗,术后病理B2型胸腺瘤,术毕即刻出现四肢无力、抬头困难、呼吸无力伴无法脱机,术后第1天意识完全清醒仍无法脱机,新斯的明试验阳性,诊断术后新发MC,经溴吡斯的明联合静脉注射用人免疫球蛋白（pH4）治疗治疗后痊愈。结论单纯胸腺瘤术后早期新发MC罕见,保证患者生命安全的关键在于及早诊断和合理治疗,单纯胸腺瘤在围手术期也应注意规避术后发生MC的高危因素。

关键词: 胸腺瘤, 重症肌无力危象, 术后并发症

Abstract: Objective To investigate the risk factors and preventive measures for new-onset myasthenic crisis （MC） early after thymoma surgery. Methods Retrospective analysis of the clinicopathological data of a case of new MC in the early postoperative period after surgery for simple thymoma in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, and review of the relevant literature. Results A young patient underwent surgical treatment for a mediastinal tumor, and the postoperative pathology showed type B2 thymoma, and immediately after the operation he had difficulty in lifting his four limbs and head, respiratory weakness, and was unable to be taken off the machine. On the first day after surgery, he was fully conscious but still unable to be taken off the machine. The Neostigmine test （+） diagnosed a new onset of MC after surgery. He was cured by a combination of bromostigmine and intravenous injection of human immunoglobulin （pH4）. Conclusion Early new-onset MC in the postoperative period of simple thymoma is rare, and the key to ensuring the life safety of patients is early diagnosis and rational treatment, and the high-risk factors of postoperative MC in simple thymoma should also be avoided in the perioperative period.

Key words: thymoma, myasthenic crisis, postoperative complications

中图分类号:

R734.5

杨连凯, 宫维勇. 单纯胸腺瘤术后早期新发重症肌无力危象1例并文献复习[J]. 岭南现代临床外科, 2025, 25(04): 246-249.

YANG Lian-kai, GONG Wei-yong. New-onset myasthenia gravis crisis in the early postoperative period after simple thymoma： a case report and review of the literature[J]. Lingnan Modern Clinics In Surgery, 2025, 25(04): 246-249.

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