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目的 研究重症肌无力的外科治疗。方法 从 1974年 3月～ 1999年 3月 ,采用胸腺切除治疗各型重症肌无力患者 38例 ,其中并发胸腺瘤 18例。结果 全组手术疗效满意 ,无手术死亡。术后随访 34例 ,按 Mondon标准判定疗效 :缓解 13例 ,改善 15例 ,无变化 4例 ,死亡 2例。结论 认为胸腺切除是治疗重症肌无力的一种较有效的方法 ,患者一经确诊应及早手术。手术采用胸骨正中切口 ,完全切除胸腺 (胸腺瘤 ) ,彻底清扫前纵隔脂肪组织。加强围手术期处理 ,合理应用抗胆碱酯酶药物 ,做好术后呼吸道管理是降低手术并发症及死亡率的关键
Objective To study the surgical treatment of myasthenia gravis. Methods From March 1974 to March 1999, 38 patients with various myasthenia gravis were treated with thymectomy, of which 18 were complicated with thymoma. Results The results of the whole group were satisfactory and no operative death occurred. Follow-up was performed in 34 cases. The curative effect was evaluated according to the criteria of Mondon: 13 cases were relieved, 15 cases were improved, 4 cases were unchanged and 2 cases died. Conclusions that thymectomy is a more effective method of treatment of myasthenia gravis, patients should be diagnosed as soon as possible after surgery. Surgical use of the midline incision, complete removal of the thymus (thymoma), thorough anterior mediastinal adipose tissue. To strengthen the perioperative management, rational use of anticholinesterase drugs, postoperative respiratory tract management is to reduce surgical complications and mortality key