摘要
目的:评价胸腺切除治疗眼肌型重症肌无力(OMG)的远期疗效及其影响因素。方法:回顾性分析胸腺切除治疗59例OMG的临床资料,其中采用部分胸骨劈开切口44例,全胸骨劈开切口2例,电视胸腔镜经右胸前外侧径路13例。所有病例均进行随访和疗效评价。结果:全组无手术死亡,术后发生肌无力危象1例;手术有效率1年内89.8%(53/59),1-3年74.0%(37/50),3-5年86.1%(31/36),5-10年88.9%(24/27),10年以上86.7%(13/15);总缓解率37.3%,有效率为86.4%。单因素与多因素分析均显示疗效与性别、年龄、病程、手术径路及病理分型无关(P>0.05)。结论:胸腺切除是OMG的有效治疗方法,切除径路首选电视胸腔镜手术。
Objective: To evaluate the long-term outcome and relevant factors of thymectomy in ocular myasthenia gravis (OMG). Methods: 59 patients with OMG. who accepted thymectomy between October 1978 and August 2003, were studied retrospectively. The operations were performed through variant approaches including 44 partial sternal splits, 2 full sternotomies and 13 video-assisted thoracoscopic thymectomies through anterior lateral approach. And follow-up ranged from 6 to 149 months (mean 69. 8 months) was carried out in all cases. Then the long-term outcome and relevant factors were analyzed. Results: No operative death was found. Myasthenia crisis occurred postoperatively in 1 case. The effective rates were 89.8% (53/59) in 1 year, 74.0% (37/50) in 1-3 years, 86. 1%(31/36) in 3-5 years, 88.9%(24/27) in 5-10 years and 86.7% (13/15) over 10 years, respectively. The total remission rate was 37.3% and effective rate was 86. 4%. There was no correlation between the long-term outcome and sex, age. duration of disease, operative approach, pathological classification of thymus, P>0. 05. Conclusion:Thymectomy for OMG is effective, and video-assisted thoracoscopic surgery is preferred for thymectomy.
出处
《中国临床医学》
北大核心
2005年第3期398-400,共3页
Chinese Journal of Clinical Medicine