重症肌无力的外科治疗

Surgical treatment for cases with myasthenia gravis

目的 总结1991年5月～2001年12月手术治疗重症肌无力的经验。方法 11例病人均行全胸腺切除加前纵隔脂肪组织清扫术 ,按改良Osseiman标准分为Ⅰ型4例、Ⅱa型3例、Ⅱb型3例、Ⅲ型1例。随访结果按完全缓解、改善、无效进行评价。 结果 手术后完全缓解3例、改善5例、无效2例、死亡1例。结论 全胸腺切除加前纵隔脂肪组织清扫术是治疗重症肌无力的有效方法 ,除无胸腺瘤的单纯眼肌型肌无力病人需慎重考虑是否手术外 ,对其它重症肌无力病人应及早手术治疗 ,并加强围术期管理 ,积极防治肌无力危象。

Objective To reviewthe cases undergone surgical treatment f or myasthenia gravis from May,1991to Dec,2001. Methods 11patients of MG underwen t total Thymectomy with anterior mediastinal fatty tissue resection.According to Osseimans'standard,there were4cases of typeⅠ,3of typeⅡa,3of typeⅡb and1of typeⅢ.The results were evaluated by complete remission,amelioration and Ineff iciency. Results 3cases were complete remission,5cases amelioration,2cases wer e Inefficiency and1case died postoperatively. Conclusion Total Thymectomy with a nterior mediastinal fatty tissue resection is an effective method for myasthen ia gravis.Except for the simple eye-muscle-type MG patients,all MG patients sho uld undergo operation early,and appropriate perioperative management and preven tion of myasthenia crisis are important.