本文選題：胸腺瘤　切入點：病理分型　出處：《福建醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：探討胸腺瘤的（2004WHO）病理類型、Masaoka臨床分期與重癥肌無力、術后重癥肌無力危象之間是否存在相關性，對臨床診療提供幫助。 方法：回顧性分析2004年12月至2013年12月福建醫(yī)科大學附屬第一醫(yī)院行胸腺切除術的123例胸腺瘤患者臨床及病理資料，采用2004年WHO分類標準對胸腺瘤進行分類。運用統(tǒng)計學軟件SPSS for Windows19.0對胸腺瘤的病理類型、Masaoka臨床分期與重癥肌無力、術后重癥肌無力危象之間是否存在相關性做統(tǒng)計學分析。 結果：①A型胸腺瘤12例；AB型胸腺瘤38例；B1型胸腺瘤16例；B2型胸腺瘤29例；B3型胸腺瘤25例；胸腺癌3例。胸腺瘤合并重癥肌無力58例。胸腺瘤病理類型與重癥肌無力存在相關性（P＜0.05），差異有統(tǒng)計學意義，B型胸腺瘤較易合并重癥肌無力。②胸腺瘤合并重癥肌無力58例：Ⅰ期27例、Ⅱ期18例、Ⅲ期8例、Ⅳ期5例；胸腺瘤未合并重癥肌無力65例：Ⅰ期11例，Ⅱ期23例，Ⅲ期25例，Ⅳ期6例。胸腺瘤Masaoka臨床分期與重癥肌無力存在相關性（P＜0.05），合并重癥肌無力者分期較早。③58例胸腺瘤合并重癥肌無力患者中12例術后發(fā)生重癥肌無力危象。患者胸腺瘤病理類型與術后重癥肌無力危象無關（P＞0.05），，差異無統(tǒng)計學意義；胸腺瘤Masaoka臨床分期與術后重癥肌無力危象間存在相關性（P＜0.05），差異有統(tǒng)計學意義。胸腺瘤分期越晚越易發(fā)生重癥肌無力危象。 結論： 1.胸腺瘤的病理類型與重癥肌無力發(fā)生關系密切，B型胸腺瘤較易合并重癥肌無力，應注意排查是否合并重癥肌無力。 2.胸腺瘤合并重癥肌無力與胸腺瘤Masaoka臨床分期關系密切，胸腺瘤合并重癥肌無力患者，因癥狀較明顯，有利于患者及時檢查，所以胸腺瘤發(fā)現較早，分期較早。 3.胸腺瘤病理類型與胸腺瘤合并重癥肌無力患者術后肌無力危象未見明顯相關性。 4.胸腺瘤Masaoka臨床分期與胸腺瘤合并重癥肌無力患者術后肌無力危象關系密切。胸腺瘤Masaoka臨床分期越晚，病變侵犯范圍越大，神經受累程度越重，腫瘤微轉移可能性越大，腫瘤切不干凈可能性越大，術后越容易出現重癥肌無力危象。晚期胸腺瘤合并重癥肌無力者術后更應注意預防術后重癥肌無力危象的發(fā)生，及時發(fā)現重癥肌無力危象先兆并積極進行救治。 5.胸腺瘤的病理類型和Masaoka臨床分期相互結合，對臨床診療及胸腺瘤術后預防重癥肌無力有指導意義。
[Abstract]:Objective: to investigate the correlation between Masaoka clinical stage and myasthenia gravis and postoperative myasthenia gravis crisis in thymoma. Methods: the clinical and pathological data of 123 patients with thymoma underwent thymectomy from December 2004 to December 2013 in the first affiliated Hospital of Fujian Medical University were retrospectively analyzed. In 2004, WHO classification criteria were used to classify thymoma. Statistical software SPSS for Windows19.0 was used to analyze the correlation between clinical stage of thymoma and myasthenia gravis and postoperative myasthenia gravis crisis. Results there were 12 cases of Thymoma type 1A and 38 cases of type AB thymoma. There were 16 cases of Thymoma B _ 1 type B _ 2 type thymoma, 29 cases of B _ 2 type thymoma and 25 cases of B _ 3 type thymoma. 3 cases of thymic carcinoma. 58 cases of thymoma complicated with myasthenia gravis. The pathological types of thymoma were correlated with myasthenia gravis (P < 0.05). The difference was statistically significant (P < 0.05). Type B thymoma was more easily complicated with myasthenia gravis thymoma with myasthenia gravis than type B thymoma. In 58 cases, 27 cases were in stage 鈪

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