Casanova-Estruch B
Servicio de Neurología, Hospital Universitari La Fe, Valencia, España.
Rev Neurol. 1998 Apr;26(152):567-72.
We studied 77 patients with myasthenia gravis (MG) in whom thymectomy had been done between 1968 and 1992. The mean follow-up period was 7.3 years. Our aim was to analyze their clinical courses with regard to various parameters: demographic, clinical and the anatomo-pathology of the thymus. We classified the patients according to three possible situations: in remission without treatment, in remission with some type of treatment and not in remission.
We did not find any data which significantly affected the subsequent course of MG. However, there was a statistically significant improvement (p = 0.008) when the pre-thymectomy and post-thymectomy conditions of the patients were compared.
Overall, our series of cases is comparable to the majority of those presented. It should be remembered that although thymectomy has a place in the treatment of MG, and the technique is of low morbidity, precise indication for it has not yet been established. There are a considerable number of patients in whom no improvement is seen after this operation, although in 30% improvement may be expected.
我们研究了1968年至1992年间接受胸腺切除术的77例重症肌无力（MG）患者。平均随访期为7.3年。我们的目的是根据各种参数分析他们的临床病程：人口统计学、临床情况以及胸腺的解剖病理学。我们根据三种可能的情况对患者进行分类：未经治疗处于缓解期、接受某种治疗处于缓解期以及未处于缓解期。
我们未发现任何对MG后续病程有显著影响的数据。然而，比较患者胸腺切除术前和术后的状况时，有统计学上的显著改善（p = 0.008）。
总体而言，我们的病例系列与大多数已报道的病例相当。应当记住，虽然胸腺切除术在MG治疗中有一席之地，且该技术的发病率较低，但尚未确定其确切的适应症。相当一部分患者术后未见改善，不过有30%的患者可能预期会有改善。
