Factors influencing the risk of myasthenic crisis after thymectomy in myasthenia gravis patients:A meta-analysis
Objective To systematically analyze the factors influencing the risk of myasthenic crisis(MC)in myasthenia gravis(MG)patients after thymectomy.Methods The English or Chinese literature on the risk factors of MC after thymectomy in MG patients were retrieved by computer from inception to November 2023.The database included Pubmed,Embase,Cochrane Library,Web of Science,CNKI,CBM,and Wanfang.Literature screening and data extraction were conducted according to inclusion and exclusion criteria.RevMan 5.3 was used for quality assessment and meta-analysis,and Stata 14 was used for quantitative risk bias analysis.Results A total of 30 case-control or retrospective studies were included in the meta-analysis.The total number of patients was 5 550.The results of meta-analysis showed that the severity of the disease(OR=6.59,95％CI:4.33-10.01),transsternal thymectomy(OR=4.44,95％CI:2.38-8.28),the intraoperative blood loss(OR=15.52,95％CI:4.64-51.90),preoperative bulbar symptoms(OR=3.79,95％CI:2.54-5.67),MC history(OR=3.99,95％CI:3.04-5.24),postoperative pulmonary infection(OR=3.34,95％CI:2.08-5.35)and thymoma(OR=2.98,95％CI:1.77-5.01)were risk factors for MC in MG patients after thymotomy.Conclusions There are several risk factors for MC after thymectomy in MG patients.The severity of the disease,especially involving the bulbar symptoms or a history of MC,combined with thymoma,the operative mode of transsternal thymectomy,higher intraoperative bleeding,and postoperative lung infection were independent risk factors for the development of MC after thymectomy in MG patients.
万方数据
维普
