摘要
目的探讨胸腺扩大切除术治疗重症肌无力(myasthenia gravis,MG)的远期疗效及其影响因素。方法回顾性分析1997年1月-2011年12月确诊为MG并进行胸腺扩大切除+纵隔脂肪清扫手术62例患者的临床资料。术后疗效判断按照美国重症肌无力协会(MGFA)标准:完全缓解、部分缓解(以上2项称为有效)、稳定和恶化。结果总有效率为82.3%,1、3、5年有效率分别为:85.7%、89.4%、76.9%。性别构成、手术时年龄、手术后病理分型、手术前后是否发生危象、肿瘤大小、发病年龄等均与远期疗效无关(P>0.05);术前病程、Osserman分型、术前是否伴有其他疾病、术前服用激素时间与远期疗效有关(P<0.05)。胸腺扩大切除术是治疗MG有效手段;术后随随访时间的延长,缓解率和有效率逐渐提高;非胸腺瘤随随访时间延长比胸腺瘤疗效要好,但非胸腺瘤与胸腺瘤远期疗效之间无统计学差异;结论胸腺扩大切除术是治疗MG的有效手段;手术应综合考虑术前病程、Osserman分型、术前是否伴有其他疾病、术前服用激素时间,以期获得较好的远期疗效。
Objective To explore the long-term efficacy and related factors of the thymus expanding treat ment for Myasthenia Gravis. Methods We took a retrospective analysis about clinical data in 62 patients who were diagnosed as Myasthenia Gravis and received the thymus expanding resection plus mediastinal fat dissection from January 1997 to December 2011. The postoperative efficacy judgment was in accordance with the American Association of Myasthenia Gravis： complete remission, partial remission （the above two known as effective）, stab and 5 years efficient were 85. ility 7%, and deterioration. Results The total efficiency was 82.3% and the 1, 3 89.4%, 76.9% respectively. The sex composition, age at the time of operation, postoperative pathological type, whether happened crisis before and after the surgery, tumor size, age of onset were all unrelated with long-term efficacy （P〉0.05）. While preoperative course, Os serman typing, whether with other diseases before operation, steroid administration time before operation were related to the long-term efficacy （P 〈0. 05）. The thymus expanding resection was the effective means for treating Myasthenia Gravis; The remission rate and effective rate were gradually improved with the extension of postoperative follow-up time. The efficacy is better in non-thymoma than thymoma with prolonged follow-up time. But there was no statistically difference between non thymoma and thymoma in curative effect. Conclusion The thymus expanding resection is the effective means for treating Myasthenia Gravis; In order to achieve better curative effect, the preoperative course, Osserman typing, whether with other diseases before operation, steroid administration time should be comprehensive before surgery.
出处
《新疆医科大学学报》
CAS
2013年第2期208-211,共4页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金(200821147)
关键词
胸腺扩大切除术
重症肌无力
远期疗效
thymus expanding resection
myasthenia gravis
long-term efficacy
