经皮穿刺胸腺介入治疗重症肌无力10例报告  

Percutaneous paracentesis into thymus for intervene treatment of myasthenia gravis:report of 10 cases

作　　者：涂来慧[1] 蒋建明[1] 张仁琴[1] 谢企良[1] 徐伟[1] 陈夷[1] 章同华[1] 丁继军[1] 张振远[1] 王舒娅[1] 孙秀英[1] 王培军[1] 吕桃珍[1] 

机构地区：[1]上海第二军医大学附属长海医院神经科

出　　处：《中华神经科杂志》1997年第5期276-278,共3页Chinese Journal of Neurology

摘　　要：探讨重症肌无力胸腺介入治疗的方法和疗效。方法对１０例重症肌无力（ＭＧ）患者由超声或ＣＴ导向，于胸骨切迹上方经皮穿刺胸腺，用我院研制２４５０ｍＨｚ微波治疗机微波天线针分点辐射治疗，并局部注射氟美松。一般１周治疗１次，共２～３次。结果于１周内即见效，显效快。近期疗效：痊愈１例，基本痊愈３例，显著好转３例，好转３例。均未发生出血、气胸及感染并发症。９例３年后随访，痊愈及基本痊愈各２例，显著好转４例，好转１例。其中１例胸腺瘤广泛浸润纵隔大血管，开胸探查无法切除病灶，经皮穿刺胸腺活检，确诊为上皮细胞型胸腺瘤，介入治疗后病情好转。结论此疗法适用于ＭＧ伴胸腺增生或胸腺瘤、不做胸腺手术或无法手术、少年以上能配合治疗的患者。须严格掌握适应证，避免并发症。bjective To explore the method and effect of thymus intervene treatment for myasthenia gravis. Methods Guiding by ultrasonography of fan type or CT scanning,10 patients in myasthenia gravis(MG) were treated by percutaneous paracentesis above the upper margin of sternum incisurei into the thymus with heat radiation of 2 450 MHz Microwave manufactured by our hospital,and with dexamethasone injected locally, once a week for 2～3 times in general. Results The effects appeared within one week. One case was cured, 3 were cured essentially, 3 were improved signifcantly, and 3 were improved. Bleeding, pneumothorax, and infection were not seen. Three years follow up for 9 cases, showed 2 cases were cured and essentially cured respectively, 4 cases were improved markelly, and 1 case was improved. The long term effects of this treatment were significant. Conclusions This therapy is indicated for MG patients accompanied by thymus hyperplasia or thymoma without intention to perform thymectomy or being incapable to be operated. They had better not less than teenagers who are enable to cooperate with this treatment. Indications must be strictly controlled for the prevention of complications.

关 键 词：重症肌无力 胸腺 介入疗法 

分 类 号：R746.105[医药卫生—神经病学与精神病学]