41例重症肌无力合并胸腺瘤的外科治疗

Surgical treatment of myathenia gravis with thymoma in 41 patients

目的 总结重症肌无力合并胸腺瘤的外科治疗经验。方法 1992年 5月～ 2 0 0 3年 10月行扩大胸腺切除术治疗重症肌无力合并胸腺瘤病人 4 1例 ,按改良osserman标准分为Ⅰ型 9例、Ⅱa型 17例、Ⅱb型 12例、Ⅲ型 3例。随访结果按完全缓解、部分缓解、无效进行评价。结果 手术后完全缓解 2 2 .0 % ,部分缓解6 5 .8% ,无效 12 .2 % ,1例术后 2年死亡。结论 合理选择病例 ,及早手术彻底 ,完善围术期管理 ,外科治疗重症肌无力合并胸腺瘤可获得良好的疗效。

Objective: To summarize the experience of surgical treatmem of myathenia gravis with thymoma in 41 patients. Methods:41 patients with myathenia gravis and thymoma were treated by extended thymectomy from May, 1992 to Oetober, 2003. According to the modified Osserman classification, type Ⅰ was in 9 patients, type Ⅱa in 17, type Ⅱb in 12 and type Ⅲ in 3. The status of the patients after operation was evaluated as: remission, improvment and no change.Results: After extended thymectomy, 87.8% of patients had good response to surgery, 12.2% had no change.Conclusions: It is effective that myathenia gravis with thymoma is treated by extended thymectomy.