应用胸腔镜单操作孔胸腺扩大切除术治疗40例老年眼肌型重症肌无力的中、远期疗效及肌无力危象发生情况分析.docVIP

应用胸腔镜单操作孔胸腺扩大切除术治疗40例老年眼肌型重症肌无力的中、远期疗效及肌无力危象发生情况分析 　　摘 要 目的：探讨应用胸腔镜单操作孔胸腺扩大切除术治疗老年眼肌型重症肌无力的中、远期疗效及肌无力危象发生情况。方法：回顾性分析我院2008年1月-2013年1月收治的78例老年眼肌型重症肌无力患者的资料，以其中接受胸腔镜单操作孔胸腺扩大切除术治疗的40例患者为观察组、接受胸骨劈开胸腺切除术治疗的38例患者为对照组，比较两组患者的手术时间、术中出血量以及术后的镇痛药物使用量、住院时间、症状改善率和肌无力危象发生情况。结果：观察组患者的手术时间、术中出血量以及术后的镇痛药物使用量和住院时间均显著少于对照组，且术后肌无力危象发生率也显著低于对照组（分别为2.5%和15.8%），但两组患者的术后症状改善率差异无统计学意义。结论：应用胸腔镜单操作孔胸腺扩大切除术治疗老年眼肌型重症肌无力的中期疗效更好，并可显著降低患者术后肌无力危象的发生风险。 　　关键词 胸腔镜 胸腺扩大切除术 眼肌型重症肌无力 肌无力危象 　　中图分类号：R655.7; R746.1 文献标识码：B 文章编号：1006-1533（2014）23-0053-04 　　Mid- and long-term efficacy and myasthenic crisis situation 　　of thoracoscopic single hole enlarged thymectomy in the treatment 　　of 40 cases of elderly patients with ocular myasthenia gravis* 　　FANG Zheng** 　　（Department of Cardiothoracic Surgery， The First People’s Hospital of Jiujiang City， Jiangxi 332000， China） 　　Abstract Objective： To investigate the mid- and long-term efficacy and myasthenic crisis situation of thoracoscopic single hole enlarged thymectomy in the treatment of elderly patients with ocular myasthenia gravis. Methods： Seventy-eight cases of elderly patients with ocular myasthenia gravis treated from January， 2008 to January， 2013 in our hospital were retrospectively analyzed， in which they were divided into an observation group （40 cases， treated by the single hole thoracoscopic enlarged thymectomy） and a control group （38 cases， treated by sternotomy thymectomy）. The times for operation and hospitalization， the bleeding volume during operation， the amount of the use of postoperative analgesic drugs， the improvement of symptoms and the occurrence of myasthenia gravis crisis were compared between two groups. Results： The times for operation and hospitalization， the bleeding volume and the amount of the use of postoperative analgesic drugs were significantly lower in the observation group than in the control group， however， the improvement of symptoms had no significant difference between two groups. One cases （2.