胸腺切除治疗重症肌无力13 例报告

• 作 者: 徐华明 刘立群 隽兆东 元 东
• 机 构: 潍坊医学院附属医院胸心外科!潍坊 261031 ,潍坊医学院附属医院胸心外科!潍坊 261031 ,潍坊医学院附属医院胸心外科!潍坊 261031 ,潍坊医学院附属医院胸心外科!潍坊 261031
• 出 处: 潍坊医学院学报
• 发表日期: 1999年03期
• 关键词: 重症肌无力 胸腺切除 胸腺瘤 前纵隔 抗胆碱酯酶药 正中入路 胸腺组织 肌无力症状 肌无力危象 术前药

目的　评价手术切除胸腺治疗重症肌无力的疗效。方法　术前药物准备１～３周，胸骨正中入路，全部切除胸腺及肿瘤１２例，其中同时行前纵隔脂肪组织清扫９例，术后配以放化疗１例，单纯放疗２例。结果　术后早期无死亡者，术后１～３年的缓解和改善率，较１年内明显增高，约９０％，按Ｍｏｎｄｅｎ标准为：缓解３例，改善６例，术后７年死于恶性胸腺瘤复发１例。结论　重症肌无力病人，只要病情允许，应常规行手术治疗，多数可获得良好疗效。

Objective To evaluate the efficacy of surgical removal of thymus in the treatment of myasthenia gravis. Methods Preoperative preparation of drugs for 1 to 3 weeks, the median approach to the sternum, thoracic and tumor resection in all 12 cases, including simultaneous anterior mediastinal fat tissue in 9 cases, postoperative radiotherapy and chemotherapy in 1 case, 2 cases of radiotherapy alone. Results No postoperative early death, 1 to 3 years after the remission and improvement rate was significantly higher than 1 year, about 90%, according to Monden criteria: 3 cases of remission, 6 cases of improvement, 7 years after the death of malignancy One case of thymoma recurrence. Conclusion Myasthenia gravis patients, as long as the condition allows, should be routine surgical treatment, most can get good effect.