Yang D S, Nakahara K, Ohno K, Hashimoto J, Maeda H, Miyoshi S, Matsumura A, Mizuta T, Akashi A, Kawashima Y
Nihon Kyobu Geka Gakkai Zasshi. 1989 Feb;37(2):313-7.
We studied postoperative status of 14 patients with myasthenia gravis of ocular type who underwent extended thymectomy. Nine patients were in remission, three improved, and two unchanged. No patient became worse and died. The remission rates at one, three, five, and ten years after operation were 50.0%, 58.3%, 60.0%, and 80.0%. The palliation rates at one, three, five, and ten years after operation were 64.3%, 75.0%, 80.0%, and 100%. The remission rate at one year after operation in patients of ocular type was significantly (p less than 0.05) higher than that in generalized type (191 patients). The mean preoperative duration of symptoms in patients who obtained remission after surgery was 7.2 +/- 6.5 months, while mean duration was 85.6 +/- 45.8 months in those patients who could not obtain remission, indicating a significant difference (p less than 0.05) of duration of symptoms between two groups. Among 89 patients with generalized as well as ocular symptoms before extended thymectomy, 62 patients (69.7%) still complained of ocular symptoms and 48 patients (53.9%) had generalized symptoms with or without ocular symptoms in 1 to 12 years after operation. This result shows that ocular symptoms do not disappear more easily than generalized ones. We conclude that extended thymectomy should be performed even in patients with myasthenia gravis of pure ocular type.
我们研究了14例接受扩大胸腺切除术的眼肌型重症肌无力患者的术后状况。9例缓解，3例改善，2例无变化。无患者病情恶化或死亡。术后1年、3年、5年和10年的缓解率分别为50.0%、58.3%、60.0%和80.0%。术后1年、3年、5年和10年的改善率分别为64.3%、75.0%、80.0%和100%。眼肌型患者术后1年的缓解率显著高于全身型患者（191例）（p<0.05）。术后缓解患者术前症状平均持续时间为7.2±6.5个月，而未缓解患者的平均持续时间为85.6±45.8个月，两组症状持续时间差异有统计学意义（p<0.05）。在89例扩大胸腺切除术前行全身及眼部症状的患者中，62例（69.7%）在术后1至12年仍有眼部症状，48例（53.9%）有全身症状，伴或不伴有眼部症状。这一结果表明，眼部症状并不比全身症状更容易消失。我们得出结论，即使是单纯眼肌型重症肌无力患者也应行扩大胸腺切除术。
