胸腔镜胸腺切除术对无胸腺瘤重症肌无力患者生活质量的改善

Maskana Pub Date : 2019-06-27 DOI:10.18537/MSKN.10.01.04
Nathalie Pinos-Vélez, M. Congregado
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引用次数: 1

摘要

胸腺切除术作为重症肌无力治疗的一部分,已被证明可产生全部或部分临床缓解。但几乎总是,衡量这一结果的参数是定量的,比如药物用量、症状的存在与否。作为这类患者手术后生活质量的真正决定因素,心理社会领域的非常重要的因素研究较少。为此,我们进行了一项回顾性定性研究,以了解非胸腺瘤性重症肌无力患者胸腺切除术后生活质量的改善。2003年1月至2013年12月期间,17名患者符合纳入标准:扩大胸腺切除术,重症肌无力确诊,非胸腺瘤性,18岁以上。我们使用SF-36问卷,收集的数据制成表格,并用SPSS 22.0进行分析。非参数数据的Wilcoxon检验用于研究手术后生活质量的任何变化。这些患者的定量手术结果为:根据Oosterhuis量表,52.9%的患者有显著的临床改善(总缓解=5,轻度症状=3,轻度残疾=1),其中17.6%的患者在没有药物治疗的情况下有完全稳定的缓解,35.2%的患者在低剂量下有药物缓解。SF-36问卷的所有维度在胸腺切除术后均提高了中位值,p<0.05。似乎在长期胸腺切除术后,重症肌无力患者的生活质量有所改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mejoras en la calidad de vida de los pacientes con Miastenia Gravis sin timoma intervenidos con timectomía videotoracoscópica
Thymectomy as part of Myasthenia Gravis treatment has proved to produce total or partial clinical remissions. But almost always, parameters to measure this outcome were quantitative, as amount of medication, presence or absence of symptoms. Very important factors of the psychosocial field as real determinants of quality of life after surgery in this kind of patients have been less investigated. Thereto, we performed a retrospective qualitative study to know the quality of life improvement after thymectomy in non-thymomatous Myasthenia Gravis patients. Seventeen patients in the period January 2003 to December 2013 met the inclusion criteria: extended thymectomy, Myasthenia Gravis confirmed, non-thymomatous, over 18 years-old. We applied the SF-36 questionnaire and the collected data were tabulated and analysed with SPSS 22.0. The Wilcoxon test for non-parametric data was used to investigate any change in the quality of life after surgery. Quantitative surgical outcome of these patients was: 52.9% had significant clinical improvement according to the Oosterhuis scale (total remission = 5, mild symptoms = 3, mild disability = 1), of which 17.6% had complete stable remission without medication and 35.2% had pharmacological remission with low doses. All dimensions of the SF-36 questionnaire improved their median value after thymectomy, with p<0.05. It seems that there is an improvement of quality of life in patients suffering Myasthenia Gravis after extended thymectomy.
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