外科治疗重症肌无力的疗效分析

Results of myasthenia gravis treated with thymectomy

目的评价外科治疗重症肌无力的效果,探讨影响术后肌无力危象发生的因素以及预防治疗要点。方法回顾性分析1985年6月至2005年6月78例接受外科治疗重症肌无力患者的临床资料,对影响术后肌无力危象发生及程度的因素进行分析,比较不同围手术期处理方案的疗效差异。结果肌无力症状完全缓解21例,明显改善38例,改善11例,无变化8例。病程长短、血清抗乙酰胆碱受体抗体水平、Osserman 分期和胸腺病理类型均是术后肌无力危象发生的独立相关危险因素。在围手术期处理方面,新方案疗效明显优于旧方案。结论外科治疗重症肌无力具有良好的效果和可行性。

Objective To evaluate the effectiveness of thymectomy for myasthenia gravis （MG） and the relative risk factors for postoperative myasthenic crisis. Methods The clinic data of 78 cases with MG who underwent thymectomy from June 1985 to June 2005 were analyzed retrospectively. The relative risk factors of postoperative myasthenic crisis were analyzed and the deferences between new and old region of perioperative management were compared. Results The symptom of MG was complete remission in 21 cases, significantly improved in 38 cases, improved in 11 cases and unchanged in 8 cases, respectively. The symptom duration before operation, preoperative serum level of anti-acetylcholine receptor antibody, Osserman stage and pathological type of thymoma were independent relative risk factors for postoperative myasthenic crisis. The new region of perioperative management was significant better than the old one. Conclusion Surgical treatment shows significant clinical benefits for patients with MG.