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目的:总结胸腺瘤的诊断和外科治疗经验。方法:回顾性分析2001年1月至2008年12月在我科手术治疗的135例胸腺瘤患者的临床资料。结果:肿瘤完整切除123例,部分切除12例,肿瘤完整切除率91%(123/135)。住院死亡1例。5年内复发8例,复发率6%(8/134);11例失随访。重症肌无力(MG)发生率为40%(54/135),术后MG症状完全缓解21例(溴吡啶斯的明停药),改善30例(溴吡啶斯的明剂量显著减少),改善不明显或加重3例(溴吡啶斯的明需维持原剂量、增加剂量或加用皮质激素等)。结论:胸部增强CT等影像学检查是诊断胸腺瘤的主要手段。重症肌无力是常见伴随症状;胸腺瘤不宜单纯切除,无论病理分期如何均应行扩大切除,以降低复发率;Ⅱ期及以上病变进行综合治疗可提高疗效。
Objective: To summarize the experience of diagnosis and surgical treatment of thymoma. Methods: The clinical data of 135 patients with thymoma treated surgically in our department from January 2001 to December 2008 were retrospectively analyzed. Results: There were 123 cases of complete tumor resection and 12 cases of partial resection. The rate of complete tumor resection was 91% (123/135). One patient died in hospitalization. 8 cases recurred within 5 years and the recurrence rate was 6% (8/134); 11 cases were missing follow-up. The incidence of myasthenia gravis (MG) was 40% (54/135). Postoperative MG symptoms were completely relieved in 21 patients (Brown Pyridoxine discontinuation), and 30 patients improved (bright Pyridoxine significantly reduced dose). Insignificant or aggravated in 3 cases (Brown Pyridoxine need to maintain the original dose, increase the dose or add corticosteroids, etc.). Conclusion: Thoracic enhanced CT and other imaging examinations are the main methods for the diagnosis of thymoma. Myasthenia gravis is a common concomitant symptom; thymoma should not be simply removed, regardless of the pathological stage should be extended resection to reduce the recurrence rate; comprehensive treatment of stage II and above lesions can improve the efficacy.