| Objective:The characteristics of differentiated thyroid carcinoma(DTC)and the occurrence of complications after thyroid surgery in the elderly aged over 55 years were summarized and summarized in order to provide reference for clinical management of elderly patients with thyroid carcinoma.Methods:Retrospective analysis from January 2016 to October 2017,The clinical data of 173 patients with differentiated thyroid carcinoma over 55years old who were initially treated by surgery in otolaryngology,head and neck surgery,fourth Hospital of Hebei Medical University.According to different age stages,they were divided into two groups:group A:55~64 years old,group B:The age of 65 years and over.Using?~2 test to carry out univariate analysis,The definition was statistically significant when P<0.05.Results:The ratio of male and female morbidity was 1:2.93 in this study.The age ranged from 55 to 78,and the population was divided into one age group every five years.The statistical results of this study showed that the number of age groups decreased with the increase of age.The proportion of patients with early staging(stage?and?)was 49.1%,while that of patients with middle and late stage(stage?and?)was 50.9%.There was no significant difference in the positive rate of total lymph node metastasis between the two groups(P>0.05),in addition,there was no statistical difference between the central region metastasis and lateral cervical metastasis.There were significant differences in tumor diameter and extraglandular invasion between the two groups(P<0.05).However,there was no significant difference in sex(P>0.05)and the number(P>0.05)of primary lesions between the two groups,that is,there was no significant difference in sex and age at the time of visit.There were 119 cases of postoperative complications.The most serious complication was hypocalcemia(54.3%,94/173).There was significant difference in the rates of transient and permanent low calcium between the two groups(P<0.05).that is,the degree of the occurrence of low calcium after operation was more serious when the age was older.Further studies found that59.5%of hypocalcemia patients'blood calcium levels tended to be normal with calcium supplementation,and the time required was 4~9 days.There were 20 patients(21.2%)who were followed up for 10 days to 6 months after discharge.In addition,19.3%of hypocalcemia patients were still unable to return to normal after 1 year follow-up.The second serious complication was postoperative hoarseness,the incidence of which was 7.5%(13/173).The analysis showed that 5.8%of the hoarseness was due to the inevitable disconnection of recurrent laryngeal nerve after invasion of recurrent laryngeal nerve.Only 1.7%were postoperative complications.Conclusion:The aged DTC has obvious age characteristic,its course of disease is long,the stage of seeing a doctor is later,The lymph node metastasis of thyroid cancer is different from that of thyroid cancer without age,and it is mainly invasive.Early discovery and early treatment should be achieved.The severity of hypocalcemia after DTC in the elderly increases with the increase of age,and the corresponding symptomatic treatment increases the length of stay in the hospital.Prolonging the follow-up time and increasing the density of follow-up are of guiding significance for the remission and recovery of patients with low calcium.The incidence of voice hoarseness caused by surgery alone is relatively small because of the strict dissection of the recurrent laryngeal nerve.This study shows that hoarseness in elderly patients with DTC after operation is mainly related to the invasive behavior of the patients'own cancer foci.. |
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