论文部分内容阅读
目的 探讨胸腺瘤合并重症肌无力 (MG)与单纯MG的临床特征及手术疗效。方法回顾性分析 1978年至 2 0 0 3年 2 4 3例MG患者临床资料 ,比较胸腺瘤合并MG组 (6 8例 )与单纯MG组 (175例 )的临床特点 ,以及术后并发症、缓解率、生存情况。结果 胸腺瘤合并MG组较单纯MG组年龄大 [平均年龄分别为 (41± 14 )与 (2 8± 16 )岁 ,t=6 .138,P =0 0 0 0 ]、病程短 (平均分别为 10、2 4个月 ,t =3 783,P =0 0 0 0 ) ,术后肌无力危象发生率高 [分别为 5 0 0 % (34/ 6 8)与 5 7% (10 / 175 ) ,χ2=6 4 77,P =0 0 0 0〗 ,两组Osserman分型差异无显著意义 (χ2 =7 6 78,P =0 10 4 )。胸腺瘤合并MG组肌无力症状完全缓解率、部分缓解率 ,术后 1年分别为 10 2 % (6例 )、6 2 7% (37例 ) ,术后 3年分别为 2 1 6 % (8例 )、75 7% (2 8例 ) ,低于单纯MG组 [术后 1年分别为 2 2 1% (30例 )、94 1% (12 8例 ) ,术后 3年分别为 4 4 4 % (44例 )、94 9% (94例 ) ,P值分别为 0 0 4 9、0 0 0 0、0 0 15、0 0 10 ];术后 5年两组比较肌无力症状完全缓解率、部分缓解率差异无显著意义 (P =0 4 5 7,P =0 6 99)。胸腺瘤合并MG组 3、5年生存率分别为 96 3%、84 4 % ,显著低于单纯MG组的 98
Objective To investigate the clinical characteristics and surgical treatment of thymoma combined with myasthenia gravis (MG) and simple MG. Methods The clinical data of 243 MG patients from 1978 to 2003 were retrospectively analyzed. The clinical features of thymoma combined with MG group (175 cases) and thymoma combined with MG group (175 cases) were compared. The complications, Mitigation rate, survival. Results The age of thymoma with MG group was significantly higher than that of MG group alone (mean age was (41 ± 14) and (28 ± 16) years, t = 6.138 and P = 0.0000 respectively) (10, 24 months, t = 3 783, P = 0 0 0 0). The incidence of postoperative myasthenic crisis was very high (34/68 and 57%, respectively) 175), χ2 = 6 4 77, P = 0 0 0 0. There was no significant difference in Osserman classification between the two groups (χ2 = 7 6 78, P = 0 10 4). The complete remission rate and partial remission rate of the patients with thymoma and MG were 10 2% (6 cases) and 62.7% (37 cases) respectively after 1 year and 21.6% 8 cases) and 75.7% (28 cases), respectively, which were lower than that of the MG group alone (21.2% (30 cases) and 94.1% (12.8 cases) after one year and 4 cases 4 4% (44 cases), 94 9% (94 cases), P values were 0 0 4 9 0 0 0 0,0 0 15,0 0 0 0 0] There was no significant difference in response rate or partial response rate (P = 0 477, P = 0 6 99). The 3- and 5-year survival rates of thymoma combined with MG group were 96 3% and 84 4%, respectively, which were significantly lower than those of MG group 98