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重症肌无力患者感染性胸腹主动脉瘤修复术：病例报告

Infectious Thoracoabdominal Aortic Aneurysm Repair in a Patient with Myasthenia Gravis: A Case Report.

作者信息

Chiba Kiyoshi, Kinebuchi Satoshi, Komagamine Masahide, Tanigawa Kazuyoshi, Chikada Masahide, Nishimaki Hiroshi, Nawata Kan

机构信息

Department of Cardiovascular Surgery, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.

出版信息

Ann Vasc Dis. 2024 Dec 25;17(4):429-432. doi: 10.3400/avd.cr.24-00099. Epub 2024 Oct 8.

DOI:10.3400/avd.cr.24-00099
PMID:39726540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11669023/
Abstract

Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder that rarely coexists with infectious thoracoabdominal aortic aneurysms (TAAA) requiring open repair. A 57-year-old patient with MG underwent elective thoracoabdominal aortic replacement. He was diagnosed with MG (Osserman classification II A). Extent IV thoracoabdominal aortic repair was performed under general anesthesia and maintained by total intravenous anesthesia. The patient was withdrawn from the ventilator on postoperative day 5 without spinal cord ischemia and myasthenic crisis. The management of infectious TAAA with myasthenia gravis warrants not only the prevention of complications associated with the crisis but also multidisciplinary treatments for infection control.

摘要

重症肌无力（MG）是一种自身免疫性神经肌肉接头疾病，很少与需要开放修复的感染性胸腹主动脉瘤（TAAA）共存。一名57岁的重症肌无力患者接受了择期胸腹主动脉置换术。他被诊断为重症肌无力（奥斯勒曼分类II A型）。在全身麻醉下进行IV型胸腹主动脉修复，并采用全静脉麻醉维持。患者术后第5天脱离呼吸机，未发生脊髓缺血和重症肌无力危象。重症肌无力合并感染性胸腹主动脉瘤的治疗不仅需要预防与危象相关的并发症，还需要多学科治疗来控制感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/11669023/499966fdbffd/avd-17-429-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/11669023/c42d7ec0fcd8/avd-17-429-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/11669023/499966fdbffd/avd-17-429-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/11669023/c42d7ec0fcd8/avd-17-429-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7380/11669023/499966fdbffd/avd-17-429-g002.jpg

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本文引用的文献

1
Open thoracoabdominal aortic aneurysm repair in a patient with myasthenia gravis.对一名重症肌无力患者进行胸腹主动脉瘤开放修复术。
Interact Cardiovasc Thorac Surg. 2022 Feb 21;34(3):510-511. doi: 10.1093/icvts/ivab331.
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Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations.重症肌无力：流行病学、病理生理学及临床表现
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Intravenous immunoglobulin in the preparation of thymectomy for myasthenia gravis.静脉注射免疫球蛋白在重症肌无力胸腺切除术准备中的应用。
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