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目的:探讨胸腺瘤合并重症肌无力(MG)患者手术的安全性和治愈率,总结其临床经验。方法:1997年8月至2008年8月收治胸腺瘤合并MG患者39例,术前均给予抗胆碱酯酶及激素治疗,病情稳定后经胸骨正中切口行胸腺扩大切除术,术后给予呼吸机支持及药物等治疗。结果:全组无手术死亡,术后未发生肌无力及胆碱能危象,痊愈出院。随访30例,失访9例,随访时间3个月～5年,缓解25例(83.3%),明显改善5例(16.7%)。结论:在胸腺瘤合并MG患者的手术治疗中,完整良好的术前评估,完全而彻底的胸腺瘤切除及前纵隔脂肪组织清除,围术期抗胆碱酯酶及激素治疗,呼吸机支持治疗是防止手术并发症及危象发生的关键。
Objective: To investigate the safety and cure rate of thymoma combined with myasthenia gravis (MG) and summarize its clinical experience. Methods: From August 1997 to August 2008, 39 patients with thymoma and MG were treated with anticholinesterase and hormone therapy before operation. The patients underwent stable thymus enlargement resection through median sternotomy and postoperative respiration Machine support and medication treatment. Results: There was no operative death in the whole group. No postoperative muscle weakness and cholinergic crisis occurred. All patients were cured and discharged. Follow up of 30 cases, 9 cases were lost, follow-up time of 3 months to 5 years, 25 cases (83.3%) were alleviated, and 5 cases (16.7%) were significantly improved. Conclusion: In the surgical treatment of patients with thymoma and MG, a complete and good preoperative evaluation, complete and complete thymoma resection and anterior mediastinal adipose tissue clearance, perioperative anticholinesterase and hormone therapy, ventilator supportive therapy Is to prevent surgical complications and crisis of the key.