Litchfield M, Noroian E
St. Vincent Health Center, Erie, Pennsylvania 16544.
J Neurosci Nurs. 1989 Dec;21(6):375-81. doi: 10.1097/01376517-198912000-00010.
Patients with myasthenia gravis (MG) face major pulmonary problems as a part of the disease process. In this descriptive study, changes in selected pulmonary functions (respiratory rate, negative inspiratory force, tidal volume and forced vital capacity) in 14 patients diagnosed with mild or moderate MG were measured every two hours from 8:00 a.m. to 8:00 p.m. Females comprised 64% of the sample while 36% were males. All subjects received anticholinesterase medication, and some subjects received additional treatment modalities. Most of the subjects were nonsmokers or previous smokers, but two subjects continued to smoke. Ninety-three percent of the sample had forced vital capacities less than 60% of their predicted values. Myasthenic forced vital capacities were significantly lower (p = .0000) than those predicted for normal subjects. The inspiratory force for the sample was low at 8:00 a.m. as well as in females over 55 years of age. There was a wide variation in tidal volume. The comparison of myasthenic values for respiratory rate, inspiratory force and tidal volume to normal values derived from random tables and prediction equations was not significant. The major implications from this study are the need to assess pulmonary function in the hospitalized myasthenic every two hours, and the need for a program of coughing, deep breathing and sighing after medication administration when muscles are strongest.
重症肌无力（MG）患者在疾病进程中面临重大肺部问题。在这项描述性研究中，对14例诊断为轻度或中度MG的患者，从上午8:00至晚上8:00每两小时测量一次选定的肺功能（呼吸频率、吸气负压、潮气量和用力肺活量）。样本中女性占64%，男性占36%。所有受试者均接受抗胆碱酯酶药物治疗，部分受试者还接受了其他治疗方式。大多数受试者不吸烟或曾吸烟，但有两名受试者仍在吸烟。93%的样本用力肺活量低于其预测值的60%。重症肌无力患者的用力肺活量显著低于正常受试者的预测值（p = .0000）。样本的吸气力在上午8:00以及55岁以上女性中较低。潮气量存在很大差异。将重症肌无力患者的呼吸频率、吸气力和潮气量值与从随机表格和预测方程得出的正常值进行比较，差异不显著。这项研究的主要意义在于，需要每两小时对住院的重症肌无力患者进行肺功能评估，以及在用药后肌肉最强劲时开展咳嗽、深呼吸和叹气的训练计划。
