胸腔镜下胸腺扩大切除术治疗重症肌无力合并微小胸腺瘤疗效分析

doi:10.3969/j.issn.1671-7171.2018.07.002

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Abstract 【Objective】To investigate the operation, prognosis and curative effect of thoracoscopic thymic enlargement in the treatment of patients with myasthenia gravis (MG) complicated with microthymoma and thymic hyperplasia.【Methods】 A total of 84 patients with MG who were admitted to our hospital from July 2012 to July 2016 were enrolled. The patients were divided into the small thymoma group ( n =46) and the thymic hyperplasia group( n =38)according to the combination of microthymoma or thymic hyperplasia. All patients underwent thoracoscopic thymectomy, and the surgical results of the two groups were observed and the prognosis was followed up for 6 months. Univariate analysis was performed on the relationship between patients' general data, thymic pathology type and curative effect, and logistic regression model was used to analyze the influencing factors.【Results】For the general data, the effect of age less than 40 years was significantly better than that of those older than 40 years old. The operation time, intraoperative blood loss, total length of incision, drainage tube retention time, hospitalization time and other basic conditions were compared between the two groups. The difference was not statistically significant ( P > 0.05). There was no significant difference in postoperative complications between the two groups ( P > 0.05). After follow-up for 6 months, the postoperative pathological thymic hyperplasia group was better than the small thymoma group. In the logistic regression model, age was still the most important factor in comparison with postoperative pathology.【Conclusion】By logistic regression analysis, the patients with MG complicated with small thymoma had severe symptoms before operation. The effect of thoracoscopic extended resection on MG with microthymoma was positive, but the effect of operation was a little worse than that of patients with thymus hyperplasia, and there was no difference in postoperative complications. It is worth popularizing and applying in clinic because of the quick recovery after operation.

Key words： Myasthenia Gravis/CO Thymus Neoplasms/CO Thymectomy

Received: 05 January 2018

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2018.07.002 OR http://www.jcr.net.cn/EN/Y2018/V35/I7/1252

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