Osaki T, Shirakusa T, Mori S, Kawanami S, Yoshimatsu H
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Feb;41(2):175-80.
Sixty-nine patients with generalized myasthenia gravis underwent thymectomy consecutively between 1980 and 1991 and were evaluated 1 month to 120 months after operation. Extended thymectomy was performed in 43 patients and other procedures in 26. The effect of thymectomy were as follows: 14.5% of the patients achieved complete remission (no symptoms, no medication), 73.9% showed improvement; in total 88.4% had palliation. The long-term changes of the remission rate at one and five years after operation were 11.5% and 19.2%, and showed a delayed remission. The long-term changes of the improvement and palliation rate were 55.7% and 67.2% at one year, 69.2% and 88.5% at five years after operation. There was significant difference in remission rate according to age at the time of operation and age of onset, but the response did not depend on sex, presence or absence of thymoma, preoperative duration of illness, Osserman's type and operative procedure.
1980年至1991年间,69例全身型重症肌无力患者连续接受了胸腺切除术,并在术后1个月至120个月进行了评估。43例患者接受了扩大胸腺切除术,26例接受了其他手术。胸腺切除术的效果如下:14.5%的患者达到完全缓解(无症状,无需药物治疗),73.9%的患者症状改善;总计88.4%的患者病情缓解。术后1年和5年缓解率的长期变化分别为11.5%和19.2%,呈现延迟缓解。改善率和缓解率的长期变化在术后1年分别为55.7%和67.2%,术后5年分别为69.2%和88.5%。根据手术时年龄和发病年龄,缓解率存在显著差异,但反应并不取决于性别、是否存在胸腺瘤、术前病程、Osserman分型和手术方式。