【摘要】 目的为了探讨重症肌无力(MG)合并胸腺瘤的临床特点和手术治疗后的效果。方法自1983年3月￣2004年12月我们对76例MG病人实施了胸腺瘤切除术,术后69例病人出院后被随访6个月￣20年。结果28例病人的胸腺瘤为良性,48例病人的胸腺瘤为恶性。术后有35.5%的病人出现了MG危象,主要见于Ⅱb和Ⅲ型病例。术后在院死亡率为6.6%。随访结果为31.9%病人的MG症状得以治愈;23.2%病人的MG症状得以改善;5.8%病人症状同术前;36.2%病人死亡于该病。结论MG合并胸腺瘤病例特点为病情较重,发展快,术前术后易出现MG危象,围手术期死亡率较高,预后欠佳。术前药物治疗和胸腺瘤切除的早期行气管切开对于治疗重症病例非常重要。这也是预防治疗MG危象及降低围手术期死亡率有效的方法。更多还原

【Abstract】 Objective To study the clinical characteristics of MG patients with thymoma and the effects after operation. Methods Thymoma excision were performed on 76 patients with MG from March 1983 to December 2004. Sixty-nine patients after operation were followed up for 6 months to 20 years after being discharged from hospital. Results There were 28 patients with benign thymomas and 48 patients with malignant thymomas. MG crises were seen in 35.5% of patients postoperatively, most in type Ⅱ and Ⅲ. The mortality of in-patients after operation was 6.6%. The MG symptoms were relieved in 31.9%, improved in 23.2% and unchanged in 5.8% of patients. 36.2% of patients died of the disease. Conclusions The characteristics of MG with thymoma are: more severe condition of the patient, rapid advance, and more MG crises before and after operation. The perioperative mortality from MG with thymoma is higher and its prognosis is unfavourable. It is very important to treat severe cases of MG with thymoma by medication and tracheostomy with thymoma excision at the early stage after the operation. This is an effective method to prevent and treat MG crises as well as to lower the perioperative mortality.更多还原