ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA NGƯỜI BỆNH NHƯỢC CƠ SAU PHẪU THUẬT CẮT TUYẾN ỨC

Abstract

Objective: Describe the clinical and paraclinical characteristics of myasthenia gravis after thymectomy. Subjects and methods: A study was conducted on 66 patients with myasthenia gravis who underwent thymectomy at the Neurological Center, Department of Thoracic Surgery - Bach Mai Hospital from 10/2019 to 01/2023. Results: The mean age was 44.42±11.59 years old, under 50 years old (accounting for 71.2%); 65.2% were women. The mean time of disease onset was 3.28±2.84 years. The positive anti-AchR antibody test rate was 80.3%; 87.9% of repeat tests were positive. Most subjects had complete thymus resection (72.7%). Pathological results: 58.1% of the subjects had cancer; 41.9% were hyperplastic. The rate of clinical symptoms decreased after surgery, eyelid ptosis (reduced from 72.7% to 56.1%), difficulty speaking (53.0% to 22.7%), and difficulty swallowing (28.8% to 13.6%); the difference was statistically significant, p<0.05. There were no statistically significant differences before and after surgery in the symptoms of double vision, shortness of breath, and limb muscle weakness. The rate of acute myasthenic attacks before thymectomy was 43.9%, reduced to 37.9%; however, the difference was not statistically significant p>0.05. After surgery, the proportion of stage 1 patients increased from 7.6% to 41.4%; Patients with stage II or higher decreased to 57.6%. The difference in the clinical stage before and after surgery was statistically significant, p<0.05. Conclusion: Patients with myasthenia gravis after thymectomy have improved clinical symptoms.