新疆医科大学学报

目的总结胸腺瘤合并重症肌无力的围手术期处理方法及外科治疗经验。方法对1994年1月~2008年1月接受手术治疗的18例胸腺瘤合并重症肌无力患者的临床资料进行回顾性分析。结果本组无围手术期死亡病例,所有患者随访1年半,3例术后早期发生重症肌无力危象,经呼吸机辅助呼吸等抢救治疗痊愈。手术后重症肌无力症状完全缓解9例,部分缓解5例,无效4例,在术后4个月因重症肌无力、发生肺部感染及呼吸衰竭死亡1例,还有1例术后半年死于肿瘤远处转移。其余16例情况良好,有效率77.7%。结论扩大胸腺切除术与术后肿瘤的综合治疗是提高疗效的有效手段,加强围手术期处理可以防治并发症及危象。

Objective To summarize the therapeutic effect of surgical management and the perioperative treatment of thmyoma with mysthenia gravis patients.Methods The data of 18 cases of thymoma with mysthenia gravis patients were treated by surgical operation from January 1994 to January 2008 were analyzed retrospectively.Results No patient died through the operation.3 cases suffered from crisis of myasthenia gravis patients at early period after operation were cured succesfully.18 cases were followed up.Complete remission of mysthenia gravis was achieved in 9 cases,partial remission was observed in 5 cases,no improvement was happened in 4 cases.One case died from myasthenia gravis complicated by lung infection and respiration function failure after 4 months after operation,one case died of recurrent thymoma and distant metastasis after 6 months after operation.The condition of the other 16 cases is very well,the effective rate was 77.7%.Conclusion The extended thymectomy,comprehensive perioperative treament are the effective approaches to improve the prognosis.Perioperative managment is very important to avoid crisis of myasthenia gravis patients.