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目的 总结手术治疗Ⅲ型危重型重症肌无力的经验。方法 分析我院１９９０ 年４ 月至１９９９ 年３月３８ 例Ⅲ型危重型重症肌无力手术治疗的效果。手术均在全麻下进行，切除胸腺及清扫前纵隔脂肪组织。结果 术后因吸呼困难或危象行气管切开１９ 例２０ 次。无围手术期死亡，平均住院（４８ ．６ ±３６ ．６）ｄ ，所有病人出院或转科前症状均有不同程度的改善。结论 Ⅲ型危重型重症肌无力病人术后极易发生危象，预防性或及时气管切开辅助呼吸是抢救危象病人有效而安全的措施。术前准备不必强调一定模式，伴发其他免疫性疾病（ 主要为甲亢） 并非手术禁忌证。
Objective To summarize the experience of surgical treatment of type Ⅲ critical myasthenia gravis. Methods Analysis of our hospital from April 1990 to March 1999 38 cases of type III severe myasthenia gravis the effect of surgery. Surgery was performed under general anesthesia, removal of thymus and mediastinal adipose tissue before cleaning. Results Postoperative tracheotomy due to difficult breathing or crisis in 19 cases 20 times. There was no perioperative death, the average hospitalization (48.6 ± 36.6) d, all patients were discharged or pretransplantation symptoms have varying degrees of improvement. Conclusion Severe crisis of type III critically ill patients with myasthenia gravis is likely to occur after operation, and prophylactic or timely tracheotomy assisted respiration is an effective and safe measure to rescue crisis patients. Preoperative preparation need not emphasize a certain pattern, associated with other immune diseases (mainly hyperthyroidism) is not a surgical contraindication.