重症肌无力35例治疗分析

The surgical treatment of 35 cases of myasthenia gravis

目的探讨重症肌无力合理的治疗方法，以降低手术并发症率和病死率。方法回顾性分析我院35例行胸腺切除术重症肌无力患者的临床资料。Ⅰ型15例，Ⅱa型9例，Ⅱb型8例，Ⅲ型3例。采用纵劈胸骨33例，左前外侧切口2例。手术均行胸腺瘤、胸腺脂肪组织切除及纵隔脂肪组织清扫。结果随诊33例患者按Monden标准评价疗效：缓解20例（60．6％），改善10例（30．3％），无变化2例（6．1％），恶化1例（3．0％），总有效率为90．1％。结论胸腺切除术治疗重症肌无力疗效可靠，对重症肌无力患者应积极行胸腺切除术。

Objective To discuss the effective surgical treatment,and to degrade the rate of the surgical complication and the mortality. Methods The clinical data of 35 cases of myasthenia gravis who were treated by operation were retrospectively analyzed. The patients included 16 males and 19 females with age ranged from 16 to 56. There were 15 cases of type 1,9 cases of type Ⅱa,8 cases of type Ⅱ b, and 3 cases of type Ⅲ respectively according to the Osserman classification. Thymectomy with excision of the fat tissue surrounding the thymus was performed on all cases. Results The symptoms of all 20 cases （ 60.6% ） were relieved, 10 cases （ 30.3% ） were improved ,2 cases （ 6.1% ） were ineffective, and 1 case （ 3.0% ） was aggravated. The effective rate was 90.1%. Conclusion It is an effective method to treat patients with myasthenia gravis by surgical operation.