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合并胸腺瘤的重症肌无力患者术后并发肌无力危象与病理分型和临床分期的相关性分析 被引量:5

Relationships between the pathology classification, Masaoka clinical stage and postoperation myasthenic crisis in patients of myasthenia gravis with thymoma
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摘要 目的探讨重症肌无力合并胸腺瘤患者胸腺瘤切除术后并发肌无力危象与其病理分型和临床分期的相关性。方法回顾性分析2006年1月至2015年12月56例经手术治疗病理证实的重症肌无力合并胸腺瘤患者的临床资料,分析其胸腺瘤WHO组织病理分型、肿瘤大小、Masaoka临床分期及肌无力危象发生率。结果术后16例患者发生肌无力危象,统计学结果表明,肌无力危象发生率,Masaoka Ⅲ期明显高于Masaoka Ⅰ+Ⅱ期[39.39%(13/33)比13.04%(3/23)],差异有统计学意义(P〈0.05);WHO病理分型B3+C型明显高于B2型[50.00%(12/24)比14.29%(4/28)],差异有统计学意义(P〈0.01);肿瘤直径〉5 cm明显高于≤ 5 cm[10/17比15.38%(6/39)],差异有统计学意义(P〈0.01)。结论合并胸腺瘤的重症肌无力患者术后并发肌无力危象与胸腺瘤的病理分级和临床分期有相关性。胸腺瘤直径大于5 cm,临床病理类型B3以上及临床分期Ⅲ期及以上患者术后易发生肌无力危象,术前及术后早期应给予积极的综合干预措施,预防肌无力危象发生。 ObjectiveTo investigate the relationships between the pathology classification, Masaoka clinical stage and postoperation myasthenic crisis in patients of myasthenia gravis with thymoma undergoing thymectomy.MethodsClinical records of 56 patients of myasthenia gravis with thymoma from January 2006 to December 2015 who had underwent thymectomy were reviewed retrospectively. The following factors were analyzed to find the relation to the occurrence of myasthenic crisis after thymectomy: WHO pathology classification, Masaoka clinical stage and tumor size.ResultsSixteen patients experienced postoperative myasthenic crisis after thymectomy. Statistical analysis revealed that the incidence of postoperative myasthenic crisis in patients with Masaoka Ⅲ stage was significantly higher than that in patients with Masaoka Ⅰ and Ⅱ stage: 39.39%(13/33) vs. 13.04%(3/23), the incidence of postoperative myasthenic crisis in patients with WHO pathology classification B3 and C type was significantly higher than patients with WHO pathology classification B2 type: 50.00%(12/24) vs. 14.29% (4/28), the incidence of postoperative myasthenic crisis in patients with tumor size more than 5 cm was significantly lower than patients with tumor size less than 5 cm: 10/17 vs. 15.38%(6/39), and there were statistical differences (P〈0.05 or〈0.01).ConclusionsWHO pathology classification and Masaoka clinical stage are significantly correlated with the occurrence of myasthenia crisis after thymectomy. The patients with Masaoka Ⅲ stage, WHO pathology classification B3 and C type and tumor size more than 5 cm have the risk of postoperative myasthenic crisis after thymectomy. The comprehensive intervention before and after operation can prevent myasthenia crisis.
作者 向水 黄进启 郑勇 黄宏灵 蔡彦力 姚元波 李旭 Xiang Shui;Huang Jinqi;Zheng Yong;Huang Hongling;Cai Yanli;Yao Yuanbo;Li Xu(rtment of Cardiothoracic, Central Hospital of Enshi Autonomous Prefecture, Hubei Enshi 445000, Chin)
出处 《中国医师进修杂志》 2018年第7期633-636,共4页 Chinese Journal of Postgraduates of Medicine
关键词 重症肌无力 胸腺瘤 肌无力危象 病理分型 Myasthenia gravis Thymoma Myasthenic crisis WHO pathology classification
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