胸腔镜胸腺扩大切除术治疗重症肌无力的临床疗效及影响因素研究

发布时间：2018-03-28 18:09

  本文选题：胸腔镜　切入点：胸腺扩大切除术　出处：《中国内镜杂志》2017年04期

【摘要】：目的评估胸腔镜胸腺扩大切除术治疗重症肌无力(MG)的疗效,并分析影响手术疗效的因素。方法回顾性分析2011年1月-2016年5月该院收治的行胸腔镜胸腺扩大切除术的183例MG患者的临床资料,采用美国重症肌无力联盟(MGFA)标准评价手术疗效。采用单因素分析和Cox比例风险模型分析影响手术疗效的因素。结果 183例患者中,173例患者完成随访,失访10例,随访率94.5%。其中完全稳定缓解(CSR)率为66.5%、药物缓解(PR)率为7.5%、微小症状表现(MM)率为1.2%、改善(I)率为1.2%、无变化(U)率为11.6%、复发(E)率为4.6%、死亡(D)率为1.7%。进一步分析显示年龄(RR=1.53,P=0.031)、病理类型(RR=5.84,P=0.022)、MGFA分型(RR=3.72,P=0.028)是影响手术疗效的因素。结论胸腔镜扩大切除术治疗MG患者疗效显著,且年龄、病理类型及MGFA分型是影响手术疗效的主要因素。
[Abstract]:Objective to evaluate the efficacy of thoracoscopic extended thymectomy in the treatment of myasthenia gravis (MG). Methods the clinical data of 183 patients with MG treated by thoracoscopic thymectomy from January 2011 to May 2016 were analyzed retrospectively. The surgical outcome was evaluated by American Myasthenia Gravis Alliance (MGFAA) standard. Univariate analysis and Cox proportional risk model were used to analyze the factors affecting the outcome of the operation. Results 173 of 183 patients were followed up, 10 of them were not visited. The follow-up rate was 94.5.The total stable remission rate was 66.5, the drug remission PRR rate was 7.5, the minor symptom symptom MMR rate was 1.2, the improvement I) rate was 1.2, the no change Ur) rate was 11.6, the recurrence rate was 4.6, the death Drate was 1.7.The further analysis showed that the age was 1.53%, and the disease was 1.03%. RRN 5.84 P0. 022 MGFA typing and RRGFA 3.72 P0. 028) are the factors that influence the outcome of the operation. Conclusion the effect of thoracoscopic extended resection on MG patients is significant. Age, pathological type and MGFA classification were the main factors affecting the outcome of operation.
【作者单位】： 河南省胸科医院胸外一科;河南省胸科医院病理科;
【分类号】：R655.7;R746.1
，

本文编号：1677452