扩大胸腺切除治疗重症肌无力的结果分析

Results of myasthenia gravis treated by extended thymectomy

目的 总结 1990年 2月至 1999年 10月手术治疗重症肌无力的随访结果 ,并分析其预后因素。方法 5 4例病人均行扩大胸腺切除术 ,按改良Osserman标准分为I型 15例、IIa型 14例 ,IIb型 16例、III型 9例。随访结果按完全缓解、改善、无效、差进行评价。结果 手术后完全缓解 2 9 6 % ,改善4 8 1% ,无效 13 0 % ,差 9 3%。手术疗效与术前病程长短及Osserman分型有关 ,与性别、年龄、胸腺病理类型无关。结论 扩大胸腺切除术是治疗重症肌无力的有效方法 。

Objective: To evaluated the influence factors on results of surgical treatment of myasthenia gravis. Methods: Fifty four patients with myasthenia gravis (MG) were treated by extended thymectomy since February 1990 to October 1999. According to the modified Osserman classification, type I was in 15 patients, type IIa in 14, type IIb in 16 and type III in 9. The status of the patients after operation was evaluated as: remission, improvement, no change and deterioration. Results: After extended thymectomy, 77.7% of patients had good response to surgery, 13 0% had no change and 9.3% had deterioration. There was no operative death. The surgical outcome was related to the course of illness and Osserman stage. Sex, age and pathologic types of thymus seem to be of no correlation surgical outcome. Conclusion: Extended thymectomy is effective operative procedure for patients with MG and it should be considered as early as possible.