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目的:探讨电视胸腔镜与开胸手术治疗重症肌无力的疗效及安全性。方法:选取60例重症肌无力患者,按随机数字表法分为两组,观察组(32例)采用电视胸腔镜手术治疗,对照组(28例)采用开胸手术治疗,观察并记录两组围手术期指标,两组术前、术后3个月、6个月QMG评分及随访6个月期间并发症的发生情况。结果:围手术期间,两组手术时间相比差异无统计学意义(P>0.05),观察组术中出血量少于对照组,术中引流时间、住院时间及切口长度均短于对照组(P<0.05)。术前,两组QMG评分比较无统计学差异(P>0.05),术后3个月、6个月,两组QMG评分均较治疗前显著降低,且观察组QMG评分均低于对照组(P<0.05)。随访6个月期间,观察组并发症7例,对照组并发症17例,主要并发症为肺部感染,观察组并发症发生率显著低于对照组(P<0.05)。结论:采用电视胸腔镜手术治疗重症肌无力具有手术切口小、患者术后恢复快,手术安全性较高的优点。
Objective: To investigate the efficacy and safety of video-assisted thoracoscopy and thoracotomy in the treatment of myasthenia gravis. Methods: Sixty patients with myasthenia gravis were randomly divided into two groups according to the random number table. The observation group (32 cases) was treated by video-assisted thoracoscopic surgery. The control group (28 cases) was treated by thoracotomy. The two groups were observed and recorded Perioperative indicators, two groups of preoperative, postoperative 3 months, 6 months QMG score and follow-up of complications during 6 months. Results: During the perioperative period, there was no significant difference between the two groups in the operation time (P> 0.05). The bleeding volume in the observation group was less than that in the control group. The drainage time, hospitalization time and incision length were shorter in the observation group than in the control group P <0.05). Before operation, the QMG scores of the two groups showed no significant difference (P> 0.05). The QMG scores of the two groups were significantly decreased at 3 months and 6 months after operation, and the QMG scores of the observation group were lower than those of the control group P <0.05). During the follow-up period of 6 months, 7 cases of complications in the observation group and 17 cases of complications in the control group were detected. The main complication was pulmonary infection, and the complication rate in the observation group was significantly lower than that in the control group (P <0.05). Conclusion: Video-assisted thoracoscopic surgery for myasthenia gravis has the advantages of small incision, rapid postoperative recovery and high operative safety.