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1972—1981年5月,368例重症肌无力手术病人88例发现胸腺瘤,没有胸腺瘤的病人,手术自颈部进路,有胸腺瘤的病人,37次自颈部进路,48次胸骨切开,3次开胸。术后延长插管,在颈部进路6.6％,胸骨切开及开胸则为26％。平均随访一年半,242例无胸腺瘤,暂时好转24.7％,好转56.1％,失败15.2％,死亡率3.6％。76例胸腺瘤,暂时好转17.1％,好转52.5％,失败11.8％,死亡率18.3％,手术死亡率1.5％。总的远期死亡率:有包膜的胸腺瘤为10％,侵袭性胸腺瘤28％,死亡率和重症肌无力的严重性较肿瘤的直接作用要大。 (注一):血浆去除术:就是以离心法分离血浆除去血液,再注射入悬浮于柠檬酸食盐水内的压缩血球;用以得到不含红血球废物的血浆。 (注二):乙酰胆硷抗受体抗体的测量很重要,在血浆清洗法后抗体曲线下降,但需要大量肌肉,六个月后才有结果,方法又很复杂,所以不能指导临床治疗。
Between 1972 and May 1981, 368 patients with myasthenia gravis who had been diagnosed with thymoma in 88 cases, patients without thymoma, patients who had a surgical approach from the neck, patients with thymoma, 37 procedures from the neck, 48 sternums Cut open and open your chest 3 times. After prolonged cannulation, the approach in the neck was 6.6%, and the sternotomy and thoracotomy were 26%. After an average of one and a half years of follow-up, 242 cases had no thymoma, temporarily improved by 24.7%, improved by 56.1%, failed by 15.2%, and had a mortality rate of 3.6%. 76 cases of thymoma, temporarily improved 17.1%, improved 52.5%, failure 11.8%, mortality 18.3%, operative mortality 1.5%. The overall long-term mortality rate was 10% for enveloped thymoma and 28% for invasive thymoma. The severity of mortality and severity of myasthenia gravis was greater than that of tumors. (Note 1) Plasmapheresis: Blood is centrifuged to remove blood and then injected into compressed blood cells suspended in citric acid saline; it is used to obtain plasma containing no red blood cell waste. (Note 2): The measurement of acetylcholine anti-receptor antibody is very important. After the plasma washing method, the antibody curve decreases, but it requires a lot of muscles. The results are only after six months. The method is very complicated, so it cannot guide clinical treatment.