Hankins J R, Mayer R F, Satterfield J R, Turney S Z, Attar S, Sequeira A J, Thompson B W, McLaughlin J S
Ann Surg. 1985 May;201(5):618-25. doi: 10.1097/00000658-198505000-00011.
Forty-eight consecutive patients with myasthenia gravis (MG) attended by generalized weakness were treated by complete thymectomy, performed transsternally in 46 patients and through a left thoracotomy in two with thymomas. There were no operative deaths. A 12-year-old child with fulminating MG died of acute pneumonia shortly after hospital discharge. Of the remaining 47 evaluable patients, thymectomy resulted in complete remission in six, marked improvement with a reduced need for medication in 20, and mild improvement on the same dosage of medication in 18. Neither the age of the patient, nor the histopathology of the excised thymus, nor the postoperative change in acetylcholine receptor antibody titer were found to have a significant influence on the response to thymectomy. If the ten patients who were 20 years of age or younger were excluded, the patients with a shorter duration of MG achieved a better response to operation. The authors conclude that thymectomy is effective treatment for MG, regardless of the age of the patient or the type of thymic pathology.
48例伴有全身无力的重症肌无力（MG）患者接受了全胸腺切除术，其中46例经胸骨正中切开，2例有胸腺瘤的患者经左胸切口进行手术。无手术死亡病例。1例12岁暴发性MG患儿出院后不久死于急性肺炎。其余47例可评估患者中，胸腺切除术后6例完全缓解，20例明显改善，药物需求减少，18例在相同药物剂量下轻度改善。未发现患者年龄、切除胸腺的组织病理学以及术后乙酰胆碱受体抗体滴度变化对胸腺切除术的反应有显著影响。如果排除20岁及以下的10例患者，MG病程较短的患者手术效果更好。作者得出结论，无论患者年龄或胸腺病理类型如何，胸腺切除术都是治疗MG的有效方法。
