Thymoma with myasthenic syndrome
Аннотация
The frequency of thymic tumors in patients with generalized myasthenia is 9-16%, and 40% of thymomas accompanied by the development of myasthenia. The increase in autoimmune diseases in the population has led to a significant increase in the incidence myasthenia. Purpose. Improve the results of the diagnosis and surgical treatment of patients with thymoma with myasthenic syndrome. Materials and methods. Male - 34, women - 33. Distribution by age: under 14 -3, 14-30 years-24, 30-40 - 20, and 50 -12 patients, patients older than 50 - 8. The weakness and fatigue in the muscles of the upper and lower extremities 47 patients complained of, a violation of the act of swallowing and choking when taking liquid food 33, nasal voice and speech changes in 26 patients and 29 patients with diplopia. Results and their discussion: 63 patients with various forms of thymoma with myasthenic syndrome were performed surgery. Postoperative complications were noted in 9 patients. Heavy myasthenic crisis with pronounced symptoms of respiratory failure - 6 (9.52%), sternal osteomyelitis - 1 (1.58%), ligature fistula - 2 (3.17%). 1 patient held on 4 sessions of plasmapheresis. As a result of therapy, the condition of patients stabilized somewhat, myasthenic crisis cropped. Two patients in connection with the development of myasthenic crisis pronounced symptoms of respiratory failure transferred on mechanical ventilation. Other complications were stopped conservatively. Hospital mortality - not observed. CONCLUSIONS: Tumors of the thymus have absolute indications for surgery, regardless of the severity of myasthenic disorders. Surgical treatment is contraindicated in patients with a serious condition, caused by uncompensated myasthenic disorders.
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