| 双侧胸腔镜扩大胸腺切除治疗非胸腺瘤性重症肌无力 |
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| 引用本文： | 苏雷,支修益,笪宇威,张旭乡,高艳,王丹丹,张毅,王春梅,许庆生,钱坤,李元博.双侧胸腔镜扩大胸腺切除治疗非胸腺瘤性重症肌无力[J].医学研究杂志,2017,46(10):60-63. |
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| 作者姓名： | 苏雷 支修益 笪宇威 张旭乡 高艳 王丹丹 张毅 王春梅 许庆生 钱坤 李元博 |
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| 作者单位： | 100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心,100053 北京, 首都医科大学宣武医院胸外科、重症肌无力暨胸腺疾病多学科诊疗中心 |
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| 基金项目： | 北京市科委首都临床特色应用与成果推广项目（Z151100004015098） |
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| 摘 要： | 目的 探讨双侧胸腔镜辅助扩大胸腺切除（bilateral approach video-assisted thoracoscopic extended thymectomy，B-VATET）治疗非胸腺瘤性重症肌无力（nonthymomatous myasthenia gravis，Non-TMG）的可行性及安全性。方法 回顾笔者科室2014年1月~2016年3月实施B-VATET的22例Non-TMG资料。根据改良Osserman分型，Ⅰ型6例，Ⅱa型9例，Ⅱb型7例。通过分析B-VATET所用的手术时间（ΔT）、出血量（ΔVb）和切除的胸腺外脂肪组织（ΔWf）等指标对B-VATET的可行性和安全性进行评估。结果 全组无手术死亡及术后病情加重患者，平均手术时间120min。较单纯右侧胸腔镜入路扩大胸腺切除手术延长的时间（ΔT）10~50min （平均34.0min）、术中增加的出血量（ΔVb）5~30ml （平均12.5ml）、术中切除的胸腺外脂肪组织（ΔWf）为4.2~60.2g （平均18.6g）。术后病理22例均显示胸腺增生，其中在胸腺外脂肪内查见异位胸腺5例（22.7%）。术后随访3个月~2年，平均随访时间14.3个月。完全稳定缓解率72.7%（16/22）。结论 研究结果推荐采用B-VATET术式治疗Non-TMG患者。但有待于对该组病历的进行长期随访评估和更广泛的数据加以验证。
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| 关 键 词： | 胸腔镜 双侧扩大胸腺切除 异位胸腺 非瘤性重症肌无力 |
| 收稿时间： | 2017/3/15 0:00:00 |
| 修稿时间： | 2017/4/11 0:00:00 |
Bilateral Approach Video-assisted Thoracoscopic Extended Thymectomy for Nonthymomatous Myasthenia Gravis |
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| Su Lei,Zhi Xiuyi,Da Yuwei.Bilateral Approach Video-assisted Thoracoscopic Extended Thymectomy for Nonthymomatous Myasthenia Gravis[J].Journal of Medical Research,2017,46(10):60-63. |
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| Authors: | Su Lei Zhi Xiuyi Da Yuwei |
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| Institution: | Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China,Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China and Department of Thoracic Surgery, Multidisciplinary Diagnosis and Treatment Center of Myasthenia Gravis and Thymic Disease, Xuanwu Hospital of Capital Medical University, Beijing 100053, China |
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| Abstract: | |
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| Keywords: | Thoracoscopy Bilateral approach extended thymectomy Ectopic thymus Nonthymomatous myasthenia gravis |
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