胸骨部分劈开切口行扩大的胸腺切除术治疗重症肌无力

Extended thymectomy through partial sternotomy for the treatment of myasthenia gravis

目的介绍胸骨部分劈开切口行扩大的胸腺切除术治疗重症肌无力的手术方法和效果。方法2000年1月至2005年12月,采用胸骨正中部分劈开切口,对32例重症肌无力患者进行了扩大的胸腺切除手术。结果6例肌无力症状完全缓解,19例症状显著改善,5例症状轻微改善,而仅有2例手术后症状完全没有好转。结论胸骨部分劈开切口是实施扩大的胸腺切除治疗重症肌无力的一种安全、有效的手术径路,并且对患者的创伤小,避免了手术后并发症,特别是肌无力危象的发生。

Objective To introduce the surgical method and evaluate the efficacy of extend- ed thymectomy through partial sternotomy for the treatment of myasthenia gravis. Methods From Jan. 2000 to Dec. 2005, extended thymectomy was performed through partial sternotomy to treat myas- thenia gravis in 32 patients. Results 59 % （19/32） patients had complete remission of symptoms, 15 % （5/32） had a significant improvement, and 15 % （5/32） had a mild improvement. Only 6 % （2/ 32） had no improvement of clinical symptoms. Conclusion Extended thymectomy through partial sternotomy is an effective and safe surgical approach to the treatment of myasthenia gravis and can avoid the occurrence of post - operative comglications, especially myasthenic crisis.