CAJ | 학술논문

目的总结胸腔镜胸腺扩大切除治疗重症肌无力的远期疗效,并分析合并胸腺瘤对手术疗效的潜在影响.方法 2001年4月至2009年10月47例重症肌无力接受胸腔镜手术的患者分为有胸腺瘤组和无胸腺瘤组两组,评价肿瘤因素对重症肌无力胸腔镜手术效果的影响.结果 47例中男20例,女27例;平均年龄36.6岁.根据美国重症肌无力基金会(MGFA)分型:Ⅰ型18例、Ⅱa型14例、Ⅱb型14例、Ⅲa型1例.胸腺瘤组22例,无瘤组25例.随访至2011年6月,无瘤组随访20 ～ 122个月,平均57个月;失访2例.无瘤组完全稳定缓解(CSR) 78.3％,药物缓解(PR) 13.0％,微小症状表现(MM)4.3％,无恶化(W)0,无复发(E)0,死亡(D)(4.3％).胸腺瘤组分别为:50.0％、22.7％、13.6％、4.5％、9.1％和0.结论胸腔镜胸腺扩大切除治疗重症肌无力远期疗效满意,无瘤组在完全缓解率上优于有瘤组,但在总有效率上两组差异无统计学意义.
목적 총결흉강경흉선확대절제치료중증기무력적원기료효,병분석합병흉선류대수술료효적잠재영향.방법 2001년4월지2009년10월47례중증기무력접수흉강경수술적환자분위유흉선류조화무흉선류조량조,평개종류인소대중증기무력흉강경수술효과적영향.결과 47례중남20례,녀27례;평균년령36.6세.근거미국중증기무력기금회(MGFA)분형:Ⅰ형18례、Ⅱa형14례、Ⅱb형14례、Ⅲa형1례.흉선류조22례,무류조25례.수방지2011년6월,무류조수방20 ～ 122개월,평균57개월;실방2례.무류조완전은정완해(CSR) 78.3％,약물완해(PR) 13.0％,미소증상표현(MM)4.3％,무악화(W)0,무복발(E)0,사망(D)(4.3％).흉선류조분별위:50.0％、22.7％、13.6％、4.5％、9.1％화0.결론 흉강경흉선확대절제치료중증기무력원기료효만의,무류조재완전완해솔상우우유류조,단재총유효솔상량조차이무통계학의의.
Objective To evaluate the long term effect of video-assisted thoracoscopic thymectomy for myasth,enia gravis and the influence of concomitant thymoma.Methods 47 cases of myasthenia gravis were retrospectively reviewed who had received video-assisted thoracoscopic thymectomy from Apr.2001 through Oct.2009.The patients were separated to two groups with or without thymoma.Influence of oncologic factors was carefully studied.Results There were 20 males and 27 females with a mean age of 36.6 yrs.According to the typing system of the Myasthenia Gravis Foundation of America ( MGFA),the patients belonged to type Ⅰ 18 cases,type Ⅱ a 14 cases,type Ⅱ b 14 cases,and Ⅲa 1 case.22 patients were in the group with thymoma,and the other 25 in the group without thymoma.Until the deadline of follow-up time of Jun.2011,only two cases in non-thymomatous group were lost.Follow-up time was 20 to 122 months,mean 57 months.The complete stable remission rate(CSR),pharmacologic remission(PR),minimal manifestations(MM),worse(W),exacerbation(E) and died of myasthenia gravis(D) in non-thymomatous group were 78.3％,13.0％,4.3％,0,0 and 4.3％.In thymomatous group the values were 50.0％,22.7％,13.6％,4.5％,9.1％ and 0.Conclusion Video-assisted thoarcoscopic thymectomy has a satisfactory long term effect for myasthenia gravis.Thymomatous group has no different in overall effectiveness with that of non-thymomatous group although a probably lower complete stable remission rate is prompted.