摘要
目的:评价胸腺切除术对眼肌型重症肌无力患者的疗效。方法:1997年1月到2002年12月行胸腺切除术的眼肌型重症肌无力患者17例,手术采用胸骨正中切口,切除胸腺并行前纵膈脂肪清扫。疗效的评判:(1)治愈,无症状,无须药物治疗;(2)改善,症状减轻,药物减量;(3)无变化,症状和药物均无变化;(4)恶化,症状加重,药量加大,甚至死亡。结果:全组术后无严重并发症和死亡;术后病理发现胸腺增生12例(70.59％),胸腺瘤3例(17.65％)。随访6个月至6年,平均(2.58±1.59)年,术后随访1年内治愈和改善的患者有76.5％,1-3年;有72.7％,3-5年有80.0％,5年以上有66.7％。结论:胸腺切除术是一种有效、安全的治疗眼肌型重症肌无力的手段。
Objective:To assess the efficacy of thymectomy for the treatment of ocular myasthenia gravis. Methods: We retrospectively analyzed 17 patients received transsternal thymectomy for the treatment of ocular myasthenia gravis between Jan. 1997 and Dec. 2002. Sternotomy was performed and the entire thymus and all the mediastinal perithymic fat were removed. Patient responses to thymectomy were categorized as follows : cured, symptom-free and required no further medication; improved, required less medication and symptoms were less severe; unchanged, symptoms and medications were the same; worse, more severe symptoms, needed more medication, or died. Results: All patients recovered without severe morbidity and mortality. Postoperative pathological findings; hyperplasia in 12 patients (70. 59%) and thymoma in 3 patients (17. 65% ). All patients were followed up for a mean of (2. 58±1. 59) years (ranging 0. 5-6 years), and 76. 47% of them were cured or improved in 1 year, 72. 7% in 1-3 years, 80. 0% in 3-5 years, and 66. 7% over 5 years. Conclusion: Transsternal thymectomy is an effective and safe treatment for patients with ocular myasthenia gravis.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2003年第11期1173-1174,共2页
Academic Journal of Second Military Medical University
基金
上海市曙光计划基金(02SG30)
上海市青年科技启明星计划(00QB14503)
