胸腺切除治疗儿童重症肌无力43例的远期疗效及影响因素分析  

Long-term outcome and relevant factors of thymectomy for myasthenia gravis in children

作　　者：谭群友[1] 王如文[1] 蒋耀光[1] 赵云平[1] 龚太乾[1] 周景海[1] 马铮[1] 林一丹[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军胸外科中心,重庆400042

出　　处：《重庆医学》2004年第2期177-178,共2页Chongqing medicine

摘　　要：目的　评价胸腺切除治疗儿童重症肌无力 (MG)的远期疗效及其影响因素。方法　胸腺切除治疗儿童MG 4 3例并长期随访评价疗效。结果　无恶化和手术死亡。术后发生肌无力危象 1例 ,术后半年肺部感染死亡 1例。总缓解率与有效率分别为 37.2 %和 81 .4 %。疗效与性别、病程、手术径路和病理类型均无关 ,P >0 .0 5。 1 0岁以上患儿有效率 (94 .74 % )高于 1 0岁以下组 (70 .83% ) ,P <0 .0 5 ;全身型有效率 (94 .74 % )高于单纯眼肌型 (70 .83% ) ,P <0 .0 5。结论　胸腺切除治疗儿童MG疗效评价需长期随访。全身型MG应手术治疗 。Objective To evaluate the long term outcome and relevant factors of thymectomy for myasthenia gravis (MG) in children.Methods Thymectomies were performed on 43 patients(under 14 years old) with MG between October 1978 and December 2002.And follow up ranged from 6 to 95 months (mean 59.3 months) was carried out in all cases.Then the relativity between the long term outcome and some factors were analyzed.Results No operative death and post operative exacerbation were found.Myasthenia crisis occurred postoperatively in one case,and one child died due to pulmonary infection in half a year.The total remission rate was 37.2% and effective rate 81.4%.There was no correlation between the long term outcome and sex,duration of disease,operative approach,pathological classification of thymus( P >0.05).But the effective rate of cases over 10 years old (94.74%)was higher than under this age(70.83%),and there was similar finding in patients between typeⅡ and typeⅠ,( P <0.05). Conclusion Long follow up ( over 3 years) is necessary for evaluating the results of thymectomy for MG in children.Thymectomy can be recommened for children with generalized MG,but the operative indication for ocular MG should be restricted.

关 键 词：重症肌无力 儿童 胸腺切除 预后 

分 类 号：R746.1[医药卫生—神经病学与精神病学]