老年甲状腺结节的诊治经验

Diagnosis and Treatment of Thyroid Nodules Elderly

介绍笔者及科室老年甲状腺结节的诊治经验,对2003年1月至2009年12月期间共收治的144例年龄大于60岁的老年甲状腺结节患者进行分析和总结。老年甲状腺结节以多发为主;压迫症状、异物和不适感、继发性甲状腺功能亢进是老年甲状腺结节患者主要的手术指证;术中发现喉返神经和甲状旁腺有脂肪沉着;病理方面良性结节的钙化率较高;患者术后切口水肿比较明显;暂时性低钙血症的发生率较高;虽然术前麻醉ASA评分较低,但术后心肺并发症的发生率并未上升。老年甲状腺结节患者以全麻为宜,最好采用双甲近全切除术,这不仅可避免术后复发和再次手术率,更可减少甲状腺素制剂的用量,减少药物副作用。

This is present the experience of ours in thyroid nodular goiter in elderly. 144 patients whose age more than 60 years admitted to our department from January, 2003 to December, 2009. The bialateral multinodular is the main case in the elderly. Compressive symptoms,feeling uncomfortable and thyrotoxicosis were the main indications for surgery. The fatty sediment was found in the recurrent laryngeal and parathyroid gland in operation in elderly. The calcified rates of benign goiters in pathology were higher in the elderly. The edema of the wound was obvious in the elderly. The recurrence of tran- sient hypoealeemia was higher in the elderly. Although the score of the ASA class was lower in the elderly. The comorbidity rates of heart and lung were not higher. The best manner of anesthesia is the general in the elderly. The best manner of op- eration in the elderly is near total thyroideetomy,it can not only avoid the recurrent and re--operation rate,but also reduce the dosage and the side of thyroxine.