胸腺切除术治疗重症肌无力的临床研究

Thymectomy treatment myasthenia gravis effect analysis

目的:探讨胸腺切除术治疗重症肌无力的疗效。方法:对50例胸腺切除术患者应用胸腺切除术治疗。结果:所有患者术后经过顺利,手术时间60～160min,平均120min,术中平均出血量50～120ml,平均80ml,住院时间7～15d,平均8.5d。本组患者无围术期死亡,无肌无力危象发生,无气管切开,手术无上腔静脉、无名静脉损伤,无纵隔、胸骨感染。随访时间6～16个月,平均12个月,其中治愈27例,改善17例,无效6例,恶化0例,总有效率为88.0%。结论:重症肌无力发病与胸腺异常有密切关系,胸腺切除术是治疗重症肌无力最本质、最有效的方法,特别是胸腺增生的和胸腺瘤的重症肌无力患者,一旦明确且有手术适应证,主张尽早手术治疗,提高术后缓解率。

Objective Discuss thymectomy treatment myasthenia gravis effect.Methods 50 cases myasthenia gravis patients were treated by thymectomy. Results All patients were followed up successfully,operation time was 60～160 min,average 120 min,the average intraoperative blood loss was 50～120ml,average 80 ml,hospital stay was 7～15 d,average 8.5 d.This group of patients without perioperative mortality,no crisis of myasthenia without tracheotomy,surgery Supreme vena cava,innominate vein injury,no mediastinal,sternal infection.Follow-up for 6 to 16 months,average 12 months,27 cases were cured,17 cases improved,6 cases invalid,0 cases deterioration,the total effective rate was 88.0%. Conclusion Disease and myasthenia gravis thymus abnormality is closely related to,thymectomy is the treatment of myasthenia gravis the most essential and most effective way,In particular,thymic hyperplasia and thymoma with myasthenia gravis,Once clear and there is the operative indication,advocates early surgery,improve the response rate after surgery.