胸腺介入疗法治疗重症肌无力

Interventional Treatment of Thymus for Myasthenia Gravis

目的:探索一种对重症肌无力具有确切疗效,又能减少创伤性和并发症的新疗法。材料和方法:13 例重症肌无力(MG) ,CT 引导下于胸骨切迹上方经皮穿刺胸腺,用本院研制的微波治疗仪作多点微波热辐射治疗,并局部注射地塞米松。结果:13 例MG 的症状和体征于治疗后3 天内即好转,其中3 例于治疗后肌力即好转。随访3 年后,显著好转10例,好转3 例。胸腺体积于治疗后有不同程度缩小,上下径、左右径、前后径缩小率分别为24 .2 % 、31 .7 % 、34 .1 % 。胸腺内可见低密度区,由胸腺组织和水分气化及凝固性坏死所致。结论:CT 引导下经皮穿刺胸腺介入疗法对MG 疗效确切,操作简便,显效快,并发症少。适用于MG 伴胸腺瘤或胸腺增生、不愿做胸腺手术切除或无法切除、胸腺放疗效果差、能较好配合治疗的MG 患者。

Purpose:To research a new therapy to myasthenia gravis( MG) ,which is not only effective,but also haslow complications. Materials and methods:13 casesof MG weretreated by CTguided percutaneousparacentesistothethymusthrough theentryabovethe up per margin ofsternum incisure with heatradiation of 2450 MHZ microwave machine made by our hospitalin multiple sites ofthymus,and with dexamethasoneinjectedlocally.Results:The therapeutic effectto MGappearedin 3 daysafterthetreatmentin allcases.Theim medi ate effect appeared in 3 case ofthem .In follow up three years,the symptoms and signs of MG were improved obviously in 10 cases,im proved in 3 cases.Thethymus becamesmaller withthe distancesofanterior posterior,left right,up down reducedin 24 .2 % ,31 .7 % ,34 . 1 % ,respectively.The density ofthymus becamelowerin some areas dueto vapouring and condensate necrosisin thymus.Conclusion :This therapy show the definit effect on MG with theadvantages of easy manipulation ,quick therapy effectand low complications.Itisindicated for MGpatients with hyperplasia orthymoma,who are unwilling toreceivethymectony ,orcan’t be operated due toinvasion ofthymomato mediastinalvessels,or shows pooreffect by thymusradiation ,and cooperate wellin thetreatment.