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目的探讨重症肌无力患者胸腺切除外科治疗特点及疗效。方法选择我院2006年9月～2009年9月确诊为重症肌无力行胸腺切除患者43例,分析其临床表现、病理类型。本组病例均采用手术治疗:14例行胸骨正中切口胸腺切除术,29例患者行胸腔下经右胸胸腺切除术。结果6例患者出现术后并发症,其中切口愈合不良1例,肺部感染1例,房颤1例,经相应处理后治愈。发生危象3例,其中2例明确为肌无力危象,1例为胆碱能危象,经相应处理后治愈。临床疗效:缓解14例;改善17例;无变化10例;恶化2例,其中死亡1例。结论胸腺切除是治疗重症肌无力的有效手段,其疗效确切。但要注意术后危象的预防和治疗。
Objective To investigate the surgical treatment and efficacy of thymectomy in patients with myasthenia gravis. Methods Forty-three patients with myasthenia gravis diagnosed with myasthenia gravis from September 2006 to September 2009 in our hospital were selected for analysis of clinical manifestations and pathological types. This group of patients were treated by surgery: 14 cases of sternal midline incision thymus resection, 29 patients underwent thoracic right thymus resection. Results Postoperative complications occurred in 6 patients, including 1 case of poor incision healing, 1 case of lung infection and 1 case of atrial fibrillation. The patients were cured after corresponding treatment. 3 cases of crisis occurred, of which 2 cases were clearly myasthenic crisis, 1 case of cholinergic crisis, after appropriate treatment cured. Clinical Efficacy: 14 cases were relieved; 17 cases were improved; 10 cases were unchanged; 2 cases were deteriorated, of which 1 case died. Conclusion Thymectomy is an effective treatment for myasthenia gravis, and its curative effect is exact. But pay attention to the prevention and treatment of postoperative crisis.