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目的 :探讨重症肌无力 (MG)并发甲状腺机能亢进 (甲亢 )病人的临床治疗特点和外科治疗的效果。方法 :对 1 1例患 MG并发甲亢病人分别行甲状腺次全切除、胸腺切除和甲状腺次全切除同时胸腺切除 ,并对这些病例进行术后随访。结果 :本组 7例 b 型病人中 2例由于气管切开所致颈部切口感染 ,经外科治疗后痊愈。3例 ( a 型 1例 , b 型 2例 )在单纯甲状腺次全切除术后 3～ 6个月 MG复发。2例 ( a型和 b 型各 1例 )在单纯胸腺切除术后 8个月和 1 2个月 MG复发。6例 ( 型 1例、 a 型 1例、 b 型 4例 )同时实施了甲状腺次全切除和胸腺切除术 ,术后 3个月 1例MG复发 ;3例 ( a 型 1例和 b 型 2例 )的 MG缓解 ,2例 ( b 型 )的 MG改善。结论 :MG并发甲亢病例同时实施胸腺切除和甲状腺次全切除疗效好 ,但由于气管切开增加了颈部切口感染的机会。MG并发甲亢时甲状腺次全切除或胸腺切除远期效果不理想。
Objective: To investigate the clinical features and surgical treatment of patients with myasthenia gravis (MG) complicated with hyperthyroidism (Hyperthyroidism). Methods: Thirteen cases of subtotal thyroidectomy, thymectomy and subtotal thyroidectomy were performed on 11 cases of patients with hyperthyroidism complicated with hyperthyroidism. All cases were followed up. Results: Two of the seven cases of type b in our group were infected with cervical incision due to tracheotomy and recovered after surgical treatment. Three cases (1 case of type a and 2 cases of type b) relapsed MG 3 to 6 months after subtotal thyroidectomy. Two patients (1 patient in each of type a and b) relapsed MG at 8 months and 12 months after simple thymectomy. Subtotal thyroidectomy and thymectomy were performed in 6 cases (1 in type 1, 1 in type a and 4 in type b), and one case of MG relapsed 3 months after operation. Three cases (type 1 and type 2 Cases) of MG alleviation, 2 cases (b type) of MG improved. CONCLUSIONS: The combination of thymectomy and subtotal thyroidectomy in patients with hyperthyroidism complicated with MG has a good curative effect. However, tracheotomy increases the chance of cervical incision infection. MG with hyperthyroidism subtotal thyroidectomy or thymectomy long-term effect is not satisfactory.