重症肌无力外科治疗中国临床专家共识

Chinese clinical expert consensus on surgical treatment of myasthenia gravis

重症肌无力(myasthenia gravis,MG)是一种获得性自身免疫性疾病,其发病机制尚未完全阐明,目前一致认为胸腺在MG的发生发展中起关键作用,胸腺切除手术对改善预后有积极作用和重要意义。然而,由于MG临床表现和分型的多样性、胸腺区解剖位置的特殊性以及手术入路的可选择性等,胸腺切除术的适应证、手术时机、手术方式、手术径路、围手术期管理以及疗效评价等仍存在争议。鉴于此,由24位从事MG外科治疗的中国胸外科专家共同讨论制定,经反复投票、咨询和修改,初步达成一致意见并形成本共识,并给出29条推荐,旨在为目前正在或即将开展MG手术的同道提供指导和参考,规范MG外科的诊疗行为,以提高诊治MG的水平。

Myasthenia gravis(MG)is an autoimmune disease with indefinite pathogenesis.MG is closely related to thymic diseases,and thymectomy is an important way for MG treatment.However,there are some controversies regarding thymectomy,including indications,operation opportunities,operative procedures,surgical approaches,perioperative managements,and efficacy evaluations,etc.Therefore,based on the literature and the experience of Chinese experts,this consensus has been written after careful discussion and inquiry and 29 recommendations have been made,aiming to guide surgical treatment of MG and improve the clinical outcomes.