老年与非老年患者甲状腺切除手术对比分析

Comparison of the results of thyroidectomy for the elderly and non-elderly patients

目的 评价≥ 6 5岁老年组患者甲状腺切除手术的手术安全性与非老年组患者有无差异。方法 收集 1995年～1999年间香港大学玛丽医院外科 70 0例接受甲状腺切除手术的患者资料 ,分析比较老年组与非老年组患者的手术指征、手术方式、手术时间、出血量、并发症和术后住院时间等。结果 在手术指征、手术方式、术后住院时间上 ,老年组与非老年组患者之间有差异 ,但在手术出血量和并发症方面 ,两组间无统计学差异。结论 在≥ 6

Objective To evaluate the risk of thyroidectomy in elderly in comparison to the younger patients. Method From Jan 1995 to Jun 1999, seven hundred patients underwent thyroidectomy by one surgical team in Queen Mary Hospital of the University of Hongkong. Patients who were ≥65 years of age during operation were compared with younger patients with respect to indications and type of thyroidectomy, operative details and postoperative outcome. Results A higher incidence of thyroidectomy was performed for malignant, substernal and recurrent goitre in the elderly compared with younger patients. Thyroidectomy for thyrotoxicosis was performed in a larger proportion of younger compared with elderly patients. Total or complete thyroidectomy was more frequently performed in elderly compared with younger patients. The operating time and the duration of hospital stay were longer for elderly compared with younger patients. Permanent hypocalcemia and unilateral nerve palsy developed in 7 of 437(1.6%) patients and 12 of 1084(1.1%) nerves at risk respectively. There was no statistical difference in the incidence of permanent hypocalcemia or recurrent nerve palsy between elderly and younger patients. Conclusion Although thyroidectomy for the elderly is more complex because of an increased proportion of patients with malignant, substernal and recurrent goitre, it can be safely performed with a favourable outcome compared with the younger patients.