重症肌无力合并胸腺瘤的外科治疗(附31例报告)

报告１９８０年至１９９６年１０月手术治疗３１例重症肌无力合并胸腺瘤的结果。３１例占同期手术治疗１２０例重症肌无力之２５．８％。按Ｍａｓａｏｋａ分期属Ｉ期７例，Ｉ期８例，ＩＩ期１５例，ＩＶ期１例，术后１５例发生危象，均采用气管切开及辅助呼吸，１例死于危象。随访半年至８年，平均３７个月，５年内死亡６例，其中ＩＩ期４例，Ｉ期２例。结论：重症肌无力合并胸腺瘤术后危象的发生率远较未合并胸腺瘤者高，及时气管切开行辅助呼吸是处理的关键；胸腺瘤的Ｍａｓａｏｋａ病理分期与预后明显相关，肌无力的严重程度对预后亦有重要影响

Surgical Treatment of Myasthenia Gravis Associated with Thymoma(A Report of 31 Cases)

Aim:The experience of surgical treatment for myasthenia gravis(MG)associated with thymoma was reviewed in this report.Clinical material and method:Thirty one patients were operated on for MG with thymoma from 1980 to 1996.The 31 cases accounted for 25.8% in all 120 cases of MG according to the Masaoka staging system,7 were in stage I disease,8 in stage II,15 in stage III and 1 in stage IV.Result:There was one operative death,with a mortality of 3.2%.The important postoperative complications were crisis in 15 patients,and pulmonary infection in 2.The follow up was from 6 months to 8 years with an average of 37 months.6 cases died within 5 years,including 4 patients with stage with III disease and 2 with stage II.Conclusion:The incidence of postoperative crisis is closely related to thymoma.Prompt tracheostomy and assisted respiratory support are very important in the management of crisis.The prognosis of MG is significantly related to Masaoka's pathologic classification.