胸腺切除治疗重症肌无力的远期疗效  

Long term effect of thymectomy for patients with myasthenia gravis

作　　者：姚亚其[1] 陈志明[1] 庞烈文[1] 毛履琰[1] 

机构地区：[1]上海医科大学华山医院胸心外科

出　　处：《中华外科杂志》1999年第6期353-354,共2页Chinese Journal of Surgery

摘　　要：目的探讨胸腺切除治疗重症肌无力的远期疗效。方法１９９０年４月至１９９４年８月胸腺切除治疗重症肌无力１２４例中，１０４例获得远期随访，随访期平均为２３６个月。患者平均年龄２９２岁。术前病程平均为３４２个月。按改良Ｏｓｅｒｍａｎ标准分为Ⅰ型２９例、Ⅱ型６４例、Ⅲ型１１例。随访疗效评价分优、良、无效和差。结果总有效率为８２７％，无效１３５％，差１９％。２例死亡。手术疗效与临床分型、术前病程有关，与性别、胸腺组织类型无关。结论一旦重症肌无力诊断明确，应尽早手术，以获满意疗效。Objective To evaluate the long term effect of thymectomy for patients with myasthenia gravis. Methods Patients with myasthenia gravis 454 months after thymectomy were followed up. Results 124 patients with myasthenia gravis were treated by thymectomy from April 1990 to August 1994. The mean age at the time of surgery was 292. According to the modified Osserman classification. 29 patients were type , 23 typeCM) a, 41 type b and 11 type . After thymectomy 827% patients had good response to the operation. 135% had no response and 19% were even worse. Of 104 patients followed up, no early death was found and late death occurred in 2.Type patients and those with shorter preoperative course responded better.Conclusions The surgical outcome is related to clinical classification of myasthenia gravis and the duration of preoperative period. Sex and pathologic type of thymus lesion seem to be irrelevant factors to the surgical outcome. To perform thymectomy or not should be very carefully weighed for patients younger than 10 years of age.

关 键 词：重症肌无力 胸腺切除术 预后 远期疗效 

分 类 号：R746.105[医药卫生—神经病学与精神病学]