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胸腺瘤型重症肌无力患者胸腺切除术后的结局

Outcomes after Thymectomy in Patients with Thymomatous Myasthenia Gravis.

作者信息

Rabiou Sani, Toudou-Daouda Moussa, Lakranbi Marwane, Issoufou Ibrahim, Ouadnouni Yassine, Smahi Mohamed

机构信息

Department of Thoracic Surgery, General Referral Hospital of Niamey, Niamey, Niger.

Faculty of Medicine and Pharmacy, Abdou Moumouni University of Niamey, Niamey, Niger.

出版信息

J Neurosci Rural Pract. 2022 Mar 9;13(2):321-325. doi: 10.1055/s-0042-1743444. eCollection 2022 Apr.

Abstract

This article describes the clinical outcomes after thymectomy in patients with thymomatous myasthenia gravis (T-MG) managed in the department of thoracic surgery of Hassan II University Hospital of Fez, Fez, Morocco.  We performed a retrospective analysis of medical records of 16 patients with T-MG between January 2009 and January 2017.  There were 11 women and 5 men with a median age of 40 years at the thymectomy time and a median time of onset of symptoms to thymectomy of 12 months. At the preoperative evaluation (Myasthenia Gravis Foundation of America [MGFA] clinical classification), 7 patients were class II, 7 class III, and 2 class IV. Nine patients were in Masaoka stage I, and the remaining 7 patients stage II. We recorded one case of postoperative myasthenic crisis. At 3 years of follow-up after thymectomy, 6 patients had complete stable remission and the other 10 patients improved. Of these patients with clinical improvement, 6 patients were in MGFA class I and the remaining 4 patients class II.  The present study shows the beneficial effect of thymectomy in patients with T-MG. Postoperative clinical outcomes seem to be better when the preoperative severity of myasthenic symptoms is mild (MGFA class II).

摘要

本文描述了在摩洛哥非斯哈桑二世大学医院胸外科接受治疗的胸腺瘤型重症肌无力(T-MG)患者胸腺切除术后的临床结果。我们对2009年1月至2017年1月期间16例T-MG患者的病历进行了回顾性分析。其中有11名女性和5名男性,胸腺切除时的中位年龄为40岁,从症状出现到胸腺切除的中位时间为12个月。在术前评估(美国重症肌无力基金会[MGFA]临床分类)中,7例患者为II级,7例为III级,2例为IV级。9例患者处于Masaoka I期,其余7例患者为II期。我们记录了1例术后肌无力危象。胸腺切除术后3年随访时,6例患者完全稳定缓解,其他10例患者病情改善。在这些病情改善的患者中,6例患者为MGFA I级,其余4例患者为II级。本研究显示了胸腺切除术对T-MG患者的有益效果。当术前肌无力症状严重程度较轻(MGFA II级)时,术后临床结果似乎更好。

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Outcomes after Thymectomy in Patients with Thymomatous Myasthenia Gravis.胸腺瘤型重症肌无力患者胸腺切除术后的结局
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