胸腺瘤合并重症肌无力的外科治疗

Surgical treatment of thymoma associated with myasthenia gravis

目的观察胸腺瘤合并重症肌无力(MG)的外科治疗效果。方法外科治疗21例胸腺瘤合并重症肌无力患者,按Osserman标准分为Ⅰ型1例、Ⅱa型7例、Ⅱb型10例、Ⅲ型3例。结果术后5例发生危象,均采用气管切开及辅助呼吸。随访半年至6年,平均36个月,5年内死亡4例。结论胸腺瘤合并重症肌无力者较常见,宜采用手术、放疗、化疗等综合治疗。围手术期应合理应用抗胆碱酯酶药,积极防治并发症及危象。

Objective To investigate the efficacy of surgical treatment for 21 patients with thymoma associated with myasthenia gravis(MG).Methods 21 patients with thymoma associated with MG were treated surgically from 1990 to 2003.According to the Osserman staging system,stage Ⅰ was in 1 patient,stage Ⅱ in 17 patients,stage Ⅲ in 3 patients.Results The important postoperative complications were myasthenia crisis in 5 patients.With follow-up was from 6 months to 6 years,with an average of 36 months,4 cases died in 5 years.Conclusions Thymectomy is the first choice treatment of thymoma associated with MG.The incidence of postoperative crisis is very high.Prompt tracheotomy and assisted respiratory support are very important in the management of crisis.