Tracy Molly M, McRae Wes, Millichap J Gordon
Division of Neurology, Children's Memorial Hospital, Northwestern University Medical School, Chicago, Illinois 60614, USA.
J Child Neurol. 2009 Apr;24(4):454-9. doi: 10.1177/0883073808325653.
Response to thymectomy in children with juvenile myasthenia gravis was evaluated using severity and response to therapy rating scales and objective measures of hospital, intensive care, and intubation days, prethymectomy and postthymectomy, as markers of morbidity. Records of 50 patients treated for myasthenia gravis at Children's Memorial Hospital, Chicago, were reviewed. Thymectomy was performed in 13 patients; average age was 10 years. Days of intubation, intensive care, and hospitalization were significantly less postthymectomy compared to prethymectomy (P < .0001). Osserman rankings postthymectomy were mild (IIa) in 1, moderate (IIb) in 4, and severe (III) in 1. On a response to therapy scale, 4 patients were grade A (complete remission, no medication); 3 were grade B (improvement, lower drug dosage); 3 were grade C (slight improvement and no change in medication); and 3 were grade D (unchanged). Thymectomy is an effective treatment in 62% of children with myasthenia gravis, and remission is complete in 31%.
采用严重程度和治疗反应评定量表以及术前和术后住院、重症监护和插管天数等客观指标作为发病指标，评估儿童重症肌无力患者胸腺切除术后的反应。回顾了芝加哥儿童纪念医院50例重症肌无力患者的治疗记录。13例患者接受了胸腺切除术；平均年龄为10岁。与术前相比，术后插管、重症监护和住院天数显著减少（P < 0.0001）。胸腺切除术后，Osserman分级为轻度（IIa）1例，中度（IIb）4例，重度（III）1例。在治疗反应量表上，4例患者为A级（完全缓解，无需用药）；3例为B级（改善，药物剂量降低）；3例为C级（略有改善，药物无变化）；3例为D级（无变化）。胸腺切除术对62%的儿童重症肌无力患者有效，31%的患者完全缓解。
