重症肌无力伴胸腺瘤的手术治疗

本文报告了手术治疗重症肌无力伴胸腺瘤15例,占我科手术治疗重症肌无力病例之25%,无手术死亡.术后3例分别1.3、5年死于肿瘤复发,1例死于肺部感染.生存11例中,缓解4例;改善6例,无变化1例.讨论中作者认为C—T检查及胸腺癌相关抗原测定,对隐匿胸腺瘤的诊断有重要价值.加强围手术期处理,是降低手术并发症及死亡率的关键,并强调合理使用抗胆碱酯酶药物和预防肺部感染可降低肌无力危象的发生率.症状严重病例术前采用细胞毒剂治疗或血浆置换疗法,可使症状改善,增加了手术的安全性.

SURGICAL TREATMENT OF MYATHENIA GRAVIS WITH THYMOMA: A REPORT OF 15 CASES

This report documents the results of surgical therpy in 15 patients of MG with thymoma which account for 25% in all MG operated thymectomy in our department. There were no operative deaths follow-up ranged from 5 months to 8 years. Three cases died of recurrence of the tumors from postoperative one , three and five uears respectly and an-other ond died of pulmonary infection. Eleven patients were alive without recurence in which complete remission were in 4 cases improved in 6 and unchanged in one. We believe that the cTscan and CAE assay are valuablein diagnosis of occult thumoma. Pereoperative management Including adequate dose of anticholinesterase, use of cytotoxic medicing and plasma exchange in severe cases and prophylaxis of pulmonary complications are quite important to decrease the occurence of the crisis and mortality.