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胸腺电视胸腔镜治疗重症肌无力的临床

发布时间: 2012-1-21


预读:别为92%、87%,无显著统计学差别。结论:电视胸腔镜下胸腺切除术治疗重症肌无力安全可靠,具有创伤小、美观、术后恢复快、并发症少等优点。我们认为对于重症肌无力合并胸腺增生肥大或非侵袭性胸腺瘤的患者应首选电视胸腔镜下胸腺扩大切除术。      【English Abstract】 Objective:The aim of this study was to investigate t胸腺电视胸腔镜治疗重症肌无力的临床
论文中文摘要:目的:通过对电视胸腔镜下胸腺切除术与胸骨正中切口行胸腺切除术治疗重症肌无力的疗效比较,探讨电视胸腔镜下胸腺切除术在治疗重症肌无力中的临床运用效果。策略:1996年-2011年,48例确诊为重症肌无力伴胸腺瘤或胸腺增生的患者在邵逸夫医院接受手术治疗。A组为电视胸腔镜下胸腺切除术,N=25例(10例男性及8例女性合并胸腺增生;4例男性及3例女性合并胸腺瘤),B组为胸骨正中切口行胸腺切除术,N=23例(5例男性及8例女性合并胸腺增生;4例男性及6例女性合并胸腺瘤),治疗结果进行回顾性浅析探讨。比较两组在手术时间、术中出血量、胸管引流时间、胸管引流量、及术后住院时间.术后缓解率的差别。结果:A组(电视胸腔镜组)手术时间(105.42±19.03min)、术中出血量(109.25±43.89m1)、胸管引流时间(2.76±0.85d)、胸管引流量(216.14±122.42m1)及术后住院时间(5.26±1.17d)。B组(正中开胸组)手术时间(96.51±32.17min)、术中出血量(280.45±70.13m1)、胸管引流时间(3-24±0.75d)、胸管引流量(410.22±201.71m1)及术后住院时间(10.29±4.61d)。二组间比较以术中出血量、胸管引流时间、胸管引流量及术后住院时间的差别具有统计学作用(P<0.05)。两组均无住院期间死亡病例。术后随访4-40个月,二组缓解率分别为92%、87%,无显著统计学差别。结论:电视胸腔镜下胸腺切除术治疗重症肌无力安全可靠,具有创伤小、美观、术后恢复快、并发症少等优点。我们认为对于重症肌无力合并胸腺增生肥大或非侵袭性胸腺瘤的患者应首选电视胸腔镜下胸腺扩大切除术。

【English Abstract】 Objective:The aim of this study was to investigate the value of video-assisted thoracoscopic thymectomy for myasthenia gravis(MG) by comparing the thymectomy via the median sternotomy retrospectively.Methods:From1996to2011, Forty-eight patients who were confirmed to be MG preoperatively at the Department of Thoracic Surgery, Sir Run Run Shaw Hospital were divided into VATS group(Twenty-five cases including ten male and eight female with thymic hyperplasia, four male and three female with thymoma) and thoracotomy group(Twenty-three cases including five male and eight female with thymic hyperplasia, four male and six female with thymoma). To compare the operative time, blood loss during operation, the duration and volume of drainage tube left in chest postoperatively, postoperative hospitapzation days and the curative effect in two groups.Results:In VATS group, blood loss during operation, the duration and volume of postoperative drainage tube left in chest, postoperative hospitapzation days were less than those of thoracotomy group(P<0.05). There was no postoperative mortapty in two groups. During a follow-up of4-40months, symptom was improved in92%of patients in VATS group and87%in thoracotomy group(P>0.05).Conclusion:Video-assisted thoracoscopic thymectomy for myasthenia gravis is safe and feasible with the advantages of less invasion, quick recovery and good curative effect. We advocate the thoracoscopic approach for thymectomy in the treatment of MG.

【关键词】 重症肌无力; 胸腺切除术; 电视胸腔镜;
【Key words】 Myasthenia gravis; Thymectomy; Thoracoscopy; Video-assisted;
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