胸腺瘤合并重症肌无力的治疗

Treatment of thymoma with myasthenia gravis

报告32例胸腺瘤合并重症肌无力的治疗(包括术前准备、手术方法、术后药物治疗).32例不同分期的胸腺瘤,30例采用胸正中切口或胸正中切口+颈部切口,两例采用后外侧+胸正中切口.除眼肌型外,术前均给予免疫球蛋白及甲泼尼龙冲击治疗.结论:胸正中切口或胸正中切口+颈部切口可以充分切除胸腺组织,术前给予抗胆碱脂酶药物+皮质类固醇类药物及免疫球蛋白能明显降低重症肌无力危象的发生.术后合理应用抗胆碱脂酶药物和及时气管切开是抢救成功的关键.

Aim：Summary report 32 cases of thymoma with myasthenia gravis（including preoperative preparation,surgical technique,postoperative medication therapy）.32 patients with different stages of thymoma,30 cases have adopted the median splitting stermotomy or cervi-thoraco two incision.two cases have adopted the posterior lateral ＋ median splitting stermotomy.In addition to ocular,the patients were given immune globulin before operation and methylprednisolone pulse therapy.Conclusion： thymus can be fully removed with the median splitting stermotomy or cervi-thoraco two incision.preoperative anti-cholinesterase drugs,corticosteroids and immunoglobulin can significantly reduce the occurrence of myasthenia crisis.postoperative reasonable application of anti-cholinesterase drugs and timely tracheotomy is the key to successful treatment.