电视胸腔镜手术与传统胸骨正中劈开行胸腺扩大切除术治疗重症肌无力的随机对照研究  

VATS with conventional sternal split line thymus extended resection treatment of myasthenia gravis:An randomized controlled study

作　　者：毛勇 林琪 岑浩锋 申文明 刘升[3] 

机构地区：[1]宁波市鄞州第二医院心胸外科,浙江宁波315100 [2]宁波市鄞州第二医院消化科,浙江宁波315100 [3]南昌大学第一附属医院胸外科,江西南昌330006

出　　处：《中国现代医生》2014年第16期7-9,共3页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2010KYB099)

摘　　要：目的比较电视胸腔镜手术与传统胸骨正中劈开行胸腺扩大切除术治疗重症肌无力的疗效。方法选择2003～2013年在我院及南昌大学第一附属医院住院治疗的重症肌无力患者30例作为本次研究对象，其中行胸腔镜下胸腺扩大切除术患者15例设为胸腔镜组，其余15例为行传统胸骨正中劈开行胸腺扩大切除术的重症肌无力患者，设为对照组。结果胸腔镜组的手术时间明显长于对照组，但术中出血量明显少于对照组，住院时明显短于对照组（P〈0.05）。胸腔镜组治疗后总有效率80％，明显高于对照组（P〈0.05）。结论电视胸腔镜胸腺切除术治疗重症肌无力安全、有效，创伤小、出血少、并发症少、疼痛轻且术后能获得较好的美观效果，其疗效明显优于传统开胸手术。可作为治疗重症肌无力首选手段之一而在临床广泛推广和应用。Objective To compare effect of VATS with conventional sternal split line thymus extended resection in treatment of myasthenia gravis. Methods A total of 30 patients with myasthenia gravis, which expanded the line thora-coseopic resection of thymus 15 patients thoracoscopic group ,the remaining 15 cases were given traditional sternal split line extended resection of the thymus myasthenia gravis patients established control group. Results The operating time of Thoracoscopic surgery group was significantly longer than the control group, but the blood loss was significantly less than the control group, while the hospital stay of thoracoscopic surgery group was significantly shorter than the control group （P〈0.05）. The total efficiency of VATS group was 80% ,was significantly higher than the control group （P〈0.05）. Conclusion Video-assisted thoracoscopic thymectomy for myasthenia gravis is safe, and is effective,has less trauma, less bleeding, fewer complications, and postoperative pain and can get better aesthetic effect, its efficacy is superior to traditional open heart surgery.

关 键 词：重症肌无力 电视胸腔镜手术 传统胸骨正中劈开行胸腺扩大切除术 重症肌无力危象 

分 类 号：R746.1[医药卫生—神经病学与精神病学]