摘要
目的对行胸腺切除术治疗的重症肌无力病人按围术期处理，进行疗效评估。方法应用胸腺切除术治疗的６４例重症肌无力病人，手术前后口服皮质类固醇、胆碱酯酶抑制剂，静脉滴注丙种球蛋白，并行血浆置换等以缓解肌无力症状。测定外周血乙酰胆碱受体抗体（ＡＣｈＲａｂ）和胸腺瘤相关抗体（ＣＡＥａｂ）的滴度。结果病人组术后ＡＣｈＲａｂ滴度明显下降，而ＣＡＥａｂ则无明显变化。术后随访１～１０年，总缓解率为８１．３％。结论所有重症肌无力病人，只要手术前后应用皮质类固醇调整免疫功能以及胆碱酯酶抑制剂、大剂量丙种球蛋白和血浆置换疗法等缓解症状，均可接受胸腺手术治疗，不受年龄、性别和病程的限制。
Objective To assess the therapeutic effects of perioperatively phase management of thymectomy for myasthenia gravis(MG). Methods Sixty four cases of MG were treated on the basis of the perioperative management of thymectomy. The patients with MG took orally corticosteroids and cholinesterase inhibitor. Intravenous high dose immunoglobulin and plasma exchange were performed to alleviate the symptoms in the patients with generalized MG before and after operation. Peripheral blood acetycholine receptor antibody(AChRab) titers and thymoma associated antibody (CAEab) titers were determined. Results The AChRab titers were significantly decreased after operation, while CAEab titers had no obvious change. The total remission rate in the patients was 81.3% during the follow up of 1 to 10 years after the thymectomy. Conclusion Thymectomy could be performed in all the MG patients who received the treatment of corticosteroids for regulating the immune function, and had intravenous high dose immunoglobulin and plasma exchange for alleviating the symptoms before and after the operation in spite of the difference in age, sex and the course of the illness in the patients. Radical operation, proper anesthesia and appropriate use of antibiotics were essential for thymectomy to be safely performed and the long term curative effects to be enhanced.
出处
《中华神经科杂志》
CAS
CSCD
1998年第6期354-357,共4页
Chinese Journal of Neurology
