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目的比较重症肌无力(MG)伴胸腺瘤患者行胸腔镜胸腺切除和经胸骨胸腺切除术的疗效。方法回顾性分析2000至2014年276例行电视胸腔镜(电视胸腔镜组)、胸骨正中劈开(胸骨正中劈开组)和第二肋间胸骨横断小切口(胸骨横断小切口组)入路行胸腺扩大切除术的MG伴胸腺瘤患者的临床资料及其治疗效果。结果电视胸腔镜组的性别、年龄、病程、术前肺活量预计值、重症肌无力基金会分级和总有效率等数据与胸骨正中劈开组和胸骨横断小切口组比较,差异无统计学意义(P>0.05);而手术切口长度、留置引流管数、术后引流时间、术后住院时间、术后出现并发症的例数均显著低于胸骨正中劈开组和胸骨横断小切口组,差异有统计学意义(P>0.05)。结论虽然3种胸腺切除手术方式在治疗MG的总有效率方面差异无显著性,但胸腔镜手术患者的围手术期优势明显。
Objective To compare the efficacy of thoracoscopic thymectomy and thoracic thyroidectomy in patients with myasthenia gravis (MG) and thymoma. Methods A retrospective analysis was performed on 276 cases of video-assisted thoracoscopy (video-assisted thoracoscopy), median sternotomy (median sternotomy) and secondary intercostal sternotomy (mini-suture of the sternum) between 2000 and 2014 Clinical data of thymus enlargement resection in patients with MG and thymoma and its therapeutic effect. Results There was no significant difference in sex, age, course of disease, estimated preoperative lung capacity, grading and total effective rate of myasthenia gravis group in the video-assisted thoracoscopic surgery group compared with the small incision group and the median sternum group P> 0.05). However, the length of surgical incision, the number of indwelling drainage tubes, the time of postoperative drainage, the length of postoperative hospital stay and the number of postoperative complications were significantly lower than those in the median sternotomy and sternotomy groups, There was statistical significance (P> 0.05). Conclusions Although there is no significant difference in the total effective rate of MG treated by the three kinds of thymectomy, the perioperative advantage of thoracososcopic surgery is obvious.