电视胸腔镜与经胸骨胸腺切除治疗不伴胸腺瘤重症肌无力的效果  

Effect of video-assisted thoracoscopic surgery and transsternal thymectomy in the treatment of myasthenia gravis without thymoma

作　　者：卢开进 

机构地区：[1]江苏省泰州市人民医院心胸外科,江苏泰州225300

出　　处：《中国医药导报》2016年第14期119-122,共4页China Medical Herald

摘　　要：目的探讨电视胸腔镜与经胸骨胸腺切除治疗不伴胸腺瘤重症肌无力的临床效果。方法分析江苏省泰州市人民医院2008年3月~2015年2月收治的40例不伴胸腺瘤重症肌无力患者临床资料,依据手术治疗措施不同进行分组,观察组20例和对照组20例。观察组采用电视胸腔镜治疗,对照组经胸骨胸腺切除治疗。观察两组患者手术时间、术中失血量、术后引流时间、术后引流量、住院时间、临床疗效和术后并发症情况。结果观察组手术时间[（89.8±16.7）min]、术后引流时间[（1.8±0.5）d]、住院时间[（3.5±1.5）d]均短于对照组[（125.4±20.3）min、（2.5±0.6）d、（8.5±2.5）d],术中失血量[（55.5±10.3）m L]、术后引流量[（60.4±10.3）m L]均少于对照组[（98.7±12.6）m L、（90.2±12.6）m L],差异有统计学意义（P〈0.05）。观察组和对照组临床治疗总有效率分别为90%、85%,差异无统计学意义（P〉0.05）。观察组术后心房颤动、切口感染、肺部感染发生率低于对照组,差异有统计学意义（P〈0.05）。结论电视胸腔镜治疗不伴胸腺瘤重症肌无力创伤小,恢复快,疗效明显,术后并发症少,值得临床推广应用。Objective To explore clinical effect of video-assisted thoracoscopic surgery and transsternal thymectomy in the treatment of myasthenia gravis without thymoma. Methods Clinical data of 40 patients with myasthenia gravis without thymoma in People′s Hospital of Taizhou City, Jiangsu Province from March 2008 to February 2015 were analyzed.They were divided into two groups by different treatment methods, observation group was 20 cases and control group was 20 cases. Video-assisted thoracoscopic surgery was used in observation group, transsternal thymectomy was applied in control group. The operation time, intraoperative blood loss, drainage time after operation, led traffic after operation,hospital stays, clinical effects and postoperative complications between two groups were detected. Results The operation time [（89.8±16.7）min], drainage time after operation [（1.8 ±0.5）d], hospital stays [（3.5 ±1.5）d] in observation group were shorter than those in control group [（125.4±20.3）min,（2.5±0.6）d,（8.5±2.5）d]; intraoperative blood loss [（55.5±10.3）m L],led traffic after operation [（60.4±10.3）m L] in observation group were less than those in control group [（98.7±12.6）m L,（90.2±12.6）m L], the differences were statistically significant（P〈0.05）. Clinical treatment total effective rate of observation group and control group was 90% and 85% respectively, with no statistical difference（P〈0.05）. Incidence rate of postoperative atrial fibrillation, incision infection, pulmonary infection in observation group were lower than those in control group, the differences were statistically significant（P〈0.05）. Conclusion The injury of video-assisted thoracoscopic surgery in the treatment of myasthenia gravis without thymoma is little, recover is quick, curative effect is obviously, postoperative complication is little, which is worthy of clinical promotion and application.

关 键 词：电视胸腔镜 经胸骨胸腺切除 不伴胸腺瘤重症肌无力 效果 

分 类 号：R746.1[医药卫生—神经病学与精神病学]