Grant R P, Jenkins L C
Can Anaesth Soc J. 1982 Mar;29(2):112-6. doi: 10.1007/BF03007987.
In a recent report Leventhal, Orkin, and Hirsh described a scoring system felt to be of value in predicting the need for postoperative mechanical ventilation in patients with myasthenia gravis undergoing thymectomy. Leventhal, et al. identified four risk factors felt to have predictive value, namely: (1) duration of myasthenia gravis greater than or equal to 6 years, (2) chronic respiratory disease, (3) dose of pyridostigmine greater than or equal to 750 mg per day, and (4) vital capacity less than or equal to 2.9 litres. Forty-six patients with myasthenia gravis who received 68 general anaesthetics were studied retrospectively. They represented the past 10 years' anaesthetic experience with myasthenia gravis at the Vancouver General Hospital. The patients were divided into two groups: (1) those who underwent thymectomy, and (2) those who underwent procedures other than thymectomy. Using the risk factors of Leventhal, et al., a predictive score was assessed for each patient; the time of postoperative tracheal extubation was also noted for each patient. From this study it was concluded that the scoring system proposed by Leventhal, et al. may have been of some value in predicting whether or not a particular patient undergoing thymectomy was likely to need ventilation postoperatively. In 41 myasthenics who had procedures other than thymectomy, however, this scoring system was found to be of no value.
在最近的一份报告中，莱文索尔、奥金和赫什描述了一种评分系统，他们认为该系统对于预测接受胸腺切除术的重症肌无力患者术后是否需要机械通气具有重要价值。莱文索尔等人确定了四个被认为具有预测价值的风险因素，即：（1）重症肌无力病程大于或等于6年；（2）慢性呼吸系统疾病；（3）溴吡斯的明剂量大于或等于每日750毫克；（4）肺活量小于或等于2.9升。对46例接受了68次全身麻醉的重症肌无力患者进行了回顾性研究。这些患者代表了温哥华总医院过去10年对重症肌无力患者的麻醉经验。患者被分为两组：（1）接受胸腺切除术的患者；（2）接受胸腺切除术以外手术的患者。利用莱文索尔等人提出的风险因素，为每位患者评估了一个预测分数；同时记录了每位患者术后气管拔管的时间。从这项研究得出的结论是，莱文索尔等人提出的评分系统在预测接受胸腺切除术的特定患者术后是否可能需要通气方面可能具有一定价值。然而，在41例接受胸腺切除术以外手术的重症肌无力患者中，发现该评分系统没有价值。
