Heiser J C, Rutherford R B, Ringel S P
Arch Surg. 1982 May;117(5):533-7. doi: 10.1001/archsurg.1982.01380290005002.
A review of 28 patients with nonthymomatous myasthenia gravis who underwent thymectomy at the University of Colorado Health Sciences Center, Denver, from 1967 to 1979 shows significant stepwise changes in management and results. Comparison among three periods--period 1 (1967 to 1971), when thymectomy competed with prednisone,which were not given in the perioperative period (seven patients); period 2 (1974 to 1976), when thymectomy was followed by six months of prednisone therapy (ten patients); and period 3 (1977 to 1979), when prednisone was also given to prepare the patients for thymectomy (11 patients)--demonstrated a decreasing need for tracheostomy and respiratory support (86% v 10% v 0%), shorter stay in the intensive care unit (21 v 3 v 1 day), and shorter hospitalization (36 v 13 v 4 days). Remission or marked amelioration of symptoms occurred in 56% of group 1 and 100% of both groups 2 and 3. Earlier application of thymectomy and its performance through a short upper transverse sternotomy incision also contributed to the improved results.
对1967年至1979年在丹佛科罗拉多大学健康科学中心接受胸腺切除术的28例非胸腺瘤性重症肌无力患者进行回顾，结果显示在治疗管理和疗效方面有显著的逐步变化。对三个时期进行比较：第1期（1967年至1971年），胸腺切除术与泼尼松竞争，围手术期未使用泼尼松（7例患者）；第2期（1974年至1976年），胸腺切除术后接受6个月的泼尼松治疗（10例患者）；第3期（1977年至1979年），术前也给予泼尼松以让患者做好胸腺切除术准备（11例患者）。结果表明气管切开术和呼吸支持需求减少（86%对10%对0%），重症监护病房住院时间缩短（21天对3天对1天），住院时间缩短（36天对13天对4天）。第1组56%的患者症状缓解或明显改善，第2组和第3组均为100%。早期应用胸腺切除术并通过胸骨上段横切口进行手术也有助于改善疗效。
