Résumé
Objective To summarize the experience of clinical diagnosis and treatment for recurrence and progress of relieved myastbenia gravis after thymectomy. Methods 22 recurrent and progressive after relieved pa-tients with myasthenia gravis who underwent thymectomy were retrospectively analyzed. The remission therapy was conducted with combined glucocorticoid and anticholinesterase and its effectiveness was estimated. Results It was 1,17,4 as better Osserman scale Ⅰ , Ⅱ , Ⅲ respectively before operation but 15,6,1 as better Osserman scale Ⅱ , Ⅲ, Ⅳ respectively in recurrence and progress of relieved myasthenia gravis after thymectomy besides 6 with myas-thenic crisis. Complete remission and partial remission were gained in 9 patients and 12 patients respectively. There was 1 hospital-death. Conclusions Recurrence and progress can occur in any patient of relieved myasthenia gravis after thymectomy. Bulbar myasthenia gravis is usually presented as dysphagia. Reasonable administration of glucocor-tieoid could improve majority of recurrence and progress of relieved myasthenia gravis after thymectomy but responses poorly to the anticholinesterases.
Résumé
Objective To summarize the experience of the prevention and treatment on bronchopleural fistula (BF) complicated after pneumonectomy.Methods Clinical analysis of 22 cases of BF was retrospectively performed.Results The total incidence was 1.12%.The incidence of BF after total pneumonectomy was 1.7%,which was higher than that after pulmonary lobectomy (1.0%).The average time for the BF to occur was 13.8 days postoperatively.4 cases received operation again befroe healing occurred and 5 cases ended up in death (22.7%).Conclusion The key factors in preventing BF mainly lie in the suture techniques of bronchial residual stumps as well as the relevant factors influencing the healing.