302例老年甲状腺手术临床分析  

Clinical analysis of thyroid surgery in 302 elderly patients

作　　者：李翔[1] 程爱群[1] 葛睿[1] 陆琪[1] 朱捷[1] 李蔚萍[1] 

机构地区：[1]复旦大学附属华东医院普外科,上海市200040

出　　处：《老年医学与保健》2010年第1期25-27,共3页Geriatrics & Health Care

摘　　要：目的探讨近十年老年甲状腺外科疾病的发病情况、临床病理特点和诊治经验。方法回顾性分析1999年～2008年华东医院收治≥65岁老年甲状腺手术病人的临床病理资料。结果302例病人，年龄65～88岁，平均年龄（71．1±5．2）岁，男女比为1：2．15，多发结节242例，双侧结节224例。并存2种及以上病变占46．0％，结节性甲状腺肿190例，甲状腺腺瘤157例，甲状腺恶性肿瘤40例，甲状腺炎性疾病21例。甲状腺癌中，Ⅰ期20例，Ⅱ期6例，Ⅲ期2例，Ⅳ期10例。乳头状癌增加，结节性甲状腺肿手术病人发现微灶癌增加。结论老年甲状腺外科疾病有其临床和病理特点。应采取正确的外科诊治原则，改善预后。老年人通常可耐受各种甲状腺手术。Objective To discuss pathogenesis, clinical and pathologic characteristics and treatment of surgical disorders of thyroid in elderly patients during the past 10 years. Methods Clinical and pathologic data of patients older than 65 years with surgical disorders of thyroid between 1999 and 2008 were analyzed retrospectively. Results Of 302 patients （mean age 71.1 years; M/F 1 ： 2.15）, 242 patients had thyroid multiple nodules, and 224 had bilateral lobar nodules. The coexistent rate of the above two or more conditions was 46.0 %. There were 190 cases of nodular goiters, 157 cases of thyroid adenoma, 40 cases of thyroid malignant tumors, and 21 cases of thyroid inflammatory disease. Of 38 patients with thyroid carcinoma, 20 patients were in stage I, 6 patients in stage II, 2 patients in stage llI, and 10 patients in stage IV. There was a tendency of increase in papillary carcinoma, and in micro-carcinoma in surgical patients with nodular goiters in the past 10 years. Conclusion Both clinical and pathologic features of thyroid disorders were characteristic in elderly surgical patients. Correct principles for surgical diagnosis and treatment of thyroid disorders should be followed in elderly patients for the sake of improving the prognosis. Elderly patients are usually able to tolerate surgical procedures for thyroid disorders.

关 键 词：老年人 甲状腺疾病 外科手术 

分 类 号：R653[医药卫生—外科学]