CAJ | 학술논문

目的：探讨基层医院采用胸腔镜胸腺扩大切除术（ VATS)治疗重症肌无力（ MG)的可行性。方法回顾分析我院采用胸腺扩大切除术治疗的重症肌无力（非胸腺瘤)患者68例,其中胸腔镜手术34例,胸骨劈开术34例,术后随访1~6年。结果VATS组患者均在胸腔镜下完成,手术时间（90.1±15.0) min,出血（45.0±5.5) mL,胸腔引流（2.5±1.2) d,术后住院时间（7.0±1.2) d,无严重并发症,无手术死亡。胸骨劈开组手术时间（98.0±12.5) min,出血（118.5±17.5) mL,胸腔引流（4.5±1.3) d,术后住院日（11.0±2.5) d,肌无力危象2例。2组患者中远期疗效差异无统计学意义。结论胸腔镜下胸腺扩大切除治疗MG,较胸骨劈开胸腺扩大切除治疗MG更具优势,具有并发症少、疗效可靠等优点,值得基层医院推广应用。
목적：탐토기층의원채용흉강경흉선확대절제술（ VATS)치료중증기무력（ MG)적가행성。방법회고분석아원채용흉선확대절제술치료적중증기무력（비흉선류)환자68례,기중흉강경수술34례,흉골벽개술34례,술후수방1~6년。결과VATS조환자균재흉강경하완성,수술시간（90.1±15.0) min,출혈（45.0±5.5) mL,흉강인류（2.5±1.2) d,술후주원시간（7.0±1.2) d,무엄중병발증,무수술사망。흉골벽개조수술시간（98.0±12.5) min,출혈（118.5±17.5) mL,흉강인류（4.5±1.3) d,술후주원일（11.0±2.5) d,기무력위상2례。2조환자중원기료효차이무통계학의의。결론흉강경하흉선확대절제치료MG,교흉골벽개흉선확대절제치료MG경구우세,구유병발증소、료효가고등우점,치득기층의원추엄응용。
Objective To identify the availability of video-assisted thoracoscopic thymectomy. Methods Retrospectively analyzed 68 patients with myasthenia gravis who underwent thymectomy including 34 cases of video-assisted thoracoscopic thymectomy and 34 cases of transsternal thymectomy,and the patients were followed up for 16 years. Results Patients of the VATS group were given video-assisted thora-coscopic thymectomy. The mean operative time was (90. 1 ± 15. 0) min,mean blood loss was (45. 0 ± 5. 5) mL,mean chest tube drainage time was (2. 5 ± 1. 2) days and mean postoperative hospital stay was (7. 0 ± 1. 2) days in VATS group,and there was no serious complica-tions and surgical death. The mean operative time was (98. 0 ± 12. 5) min,mean blood loss was (118. 5 ± 17. 5) mL,mean chest tube drain-age time was (4. 5 ± 1. 3) days and mean postoperative hospital stay was (11. 0 ± 2. 5) days in transsternal thymectomy group. 3 patients de-veloped MG crisis. There was no significant difference in mid-and long-term effects between the two groups(P>0. 05). ConclusionVideo-as-sisted thoracoscopic thymectomy for MG is safe and feasible with the advantage of less invasion,less surgical trauma,lower rate of complica-tion,and good curative effect compared with transsternal thymectomy.