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Surgical Treatment And Clinical Significance Of Quantitative Score For Myasthenia Gravis

Posted on:2010-05-12Degree:MasterType:Thesis
Country:ChinaCandidate:L F ZhaoFull Text:PDF
GTID:2144360275477142Subject:Clinical Medicine
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Objective The aim of this study was to examine the thoracoscopic versus open approaches(transsternal) to thymectomy in patients with myasthenia gravis(MG).Methods The data of 61 patients with thymectomy by thoracoscopic approach were analyzed retrospectively and compared to the open group of 39 patients.Then we study the patient selection,operative techniques,perioperative management and results for thoracoscopic approach.Results The thoracoscopic group had a mean operating time of 1.687 hours compared with 1.800 hours in the open group.The thoracoscopic group had a mean estimated blood loss of 174.42ml compared with 300.75ml in the open group.The mean tracheal intubating time postoperatively for the thoracoscopic group was 9.47 hours and was 8.92 hours in the open group.The thoracoscopic group had a mean time of chest draining of 3.09 days compared with 3.90 days in the open group.The mean amount of chest draining postoperatively for the thoracoscopic group was 335.82ml and was 615.97ml in the open group.Conclusions Both thoracoscopic and open approaches to thymectomy in patients with MG are effective.The thoracoscopic group has the added benefits of decreased estimated blood loss,decreased time and amount of chest draining,and improved cosmesis compared to the open group.The mean operating time and tracheal intubating time are not obviously different between the two groups. Objective The evaluation of surgical resection of thymic the effectiveness of the treatment of myasthenia gravis as well as the practical value of the scale score,we explored in this 2000 by the United States in association with myasthenia gravis (MGFA) proposed quantitative MG score table - QMG scale applicationMethods 26 patients with an established diagnosis of MG who underwent thymectomy from May 2003 to April 2008 were included.After collecting their data, we recorded every patient's QMG scores four times:preoperation,7 days after operation,1 month after operation and 3 months after operation.The data were analyzed by proper statistic method..Results QMG score was correlated with clinical classification of MG to a certain extent.But one may have higher classification and lower QMG score.QMG score decreased with thymectomy and the time of follow-up.Conclusions QMG score is an important reference for judging a patient's MG classification.The decrease of QMG score after thymectomy might be useful way to evaluate the effect of the operation,when the influence of medication is also taken into consideration.
Keywords/Search Tags:Myasthenia Gravis, Thymectomy, Video-assisted Thoracoscopic Surgery, Quantitative Myasthenia Gravis Score, (QMG), evaluation
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