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胸腺瘤患者重症肌无力的外科治疗

[Surgical treatment of myasthenia gravis in patients with thymoma].

作者信息

Ishii N, Matsuoka H, Okada M, Miyamoto Y, Jinnai K, Okada M

机构信息

Department of Surgery, Kobe University School of Medicine, Japan.

出版信息

Kyobu Geka. 1993 Jan;46(1):54-9.

PMID:8418361
Abstract

During the 18 years period from 1972 to 1990 fifty-two patients with thymoma, including 13 with thymoma and myasthenia gravis (MG), underwent surgical treatment in our hospital. During the same period 27 patients without thymoma underwent surgical intervention for MG. These patients were assessed from the clinical manifestations, clinical effects for MG, and prognosis. The improved effects of surgery for MG with or without thymoma could be yearly obtained after operation. Palliation and remission rates of the 10 patients of MG with thymoma, excluded postthymectomy MG, were very poor in comparison with that of the 27 patients of MG without thymoma. Further more, the prognosis of the 13 patients of thymoma with MG was worse than that of 39 patients of thymoma without MG. The association of thymoma and progressive severity of disease related closely the influence of delayed response to surgical intervention and prognosis. In conclusion, aggressive surgical resection followed by chemo-radiotherapy was the best treatment for the invasive thymoma. Postoperative intensive care for MG crisis and recurrence of thymoma improved the effect to surgical intervention and revealed the good prognosis.

摘要

1972年至1990年的18年间,我院对52例胸腺瘤患者进行了手术治疗,其中13例合并重症肌无力(MG)。同期,27例无胸腺瘤的MG患者接受了手术干预。对这些患者从临床表现、MG的临床疗效及预后等方面进行了评估。无论有无胸腺瘤,MG手术治疗后的改善效果每年均可获得。与27例无胸腺瘤的MG患者相比,10例有胸腺瘤的MG患者(排除胸腺切除术后MG)的缓解率和缓解质量非常差。此外,13例合并MG的胸腺瘤患者的预后比39例无MG的胸腺瘤患者更差。胸腺瘤与疾病进行性加重的关联与手术干预延迟反应及预后的影响密切相关。总之,积极的手术切除后进行放化疗是侵袭性胸腺瘤的最佳治疗方法。术后对MG危象和胸腺瘤复发的重症监护改善了手术干预的效果并显示出良好的预后。

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