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目的:探索一种对重症肌无力具有确切疗效,又能减少创伤性和并发症的新疗法。材料和方法:13 例重症肌无力(MG) ,CT 引导下于胸骨切迹上方经皮穿刺胸腺,用本院研制的微波治疗仪作多点微波热辐射治疗,并局部注射地塞米松。结果:13 例MG 的症状和体征于治疗后3 天内即好转,其中3 例于治疗后肌力即好转。随访3 年后,显著好转10例,好转3 例。胸腺体积于治疗后有不同程度缩小,上下径、左右径、前后径缩小率分别为24 .2 % 、31 .7 % 、34 .1 % 。胸腺内可见低密度区,由胸腺组织和水分气化及凝固性坏死所致。结论:CT 引导下经皮穿刺胸腺介入疗法对MG 疗效确切,操作简便,显效快,并发症少。适用于MG 伴胸腺瘤或胸腺增生、不愿做胸腺手术切除或无法切除、胸腺放疗效果差、能较好配合治疗的MG 患者。
OBJECTIVE: To explore a new therapy that has the exact effect on myasthenia gravis but also reduces trauma and complications. MATERIALS AND METHODS: Thirteen cases of myasthenia gravis (MG) were treated by CT. Thymus was percutaneously punctured above the notch of the sternum, and treated with multi-point microwave radiotherapy using the microwave therapeutic apparatus developed by our hospital. The dexamethasone was injected locally. Results: The symptoms and signs of 13 MG patients improved within 3 days after treatment. Three of them improved their muscle strength after treatment. Three years after follow-up, 10 cases improved significantly and 3 cases improved. The thymus volume reduced to varying degrees after treatment, the diameter of the upper and lower diameter, left and right diameter, anteroposterior diameter reduction rates were 24.2%, 31.7%, 34.1%. Low-density area visible in the thymus, caused by thymus and water vaporization and coagulation necrosis. Conclusion: CT-guided percutaneous thymus interventional therapy is effective in treating MG. It has the advantages of simple operation, rapid onset of symptoms and fewer complications. Suitable for MG with thymoma or thymus hyperplasia, do not want to do resection of thymus or unresectable, poor efficacy of thymus radiotherapy, with better treatment of MG patients.