老年人甲状腺切除术结果:系统性审查和元分析
Ahmed Ghani1, Abdullah R Ayesh2, Harisanth Rajaram3
1School of Medicine, University College Dublin, Dublin, Ireland.
JAMA otolaryngology-- head & neck surgery
|February 5, 2026
概括
甲状腺切除术对于老年人 (≥65岁) 是安全的,神经损伤,血瘤和死亡风险略有增加. 这些发现支持个性化患者咨询和术后规划,为这个不断增长的人口进行甲状腺手术.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 老年医学 老年医学
背景情况:
- 越来越多的老年患者 (≥65岁) 接受了甲状腺切除术.
- 现有的关于甲状腺切除术对老年人安全性的文献是不确定的.
- 澄清安全概况对于风险评估和患者咨询至关重要.
研究的目的:
- 评估甲状腺切除术在老年患者 (≥65岁) 的安全性.
- 为了比较经过甲状腺切除术的老年和年轻患者之间的内分泌相关并发症和死亡率.
主要方法:
- 系统搜索Ovid MEDLINE,CINAHL,Embase和Cochrane图书馆 (从开始到2025年5月).
- 包括11项英语队列研究,比较老年与年轻患者的甲状腺切除术结果.
- 使用PRISMA和ROBINS-I指南进行数据提取和偏差风险评估,随后进行随机效应元分析.
主要成果:
- 分析了427,886名患者,其中24.4%的年龄≥65岁.
- 年龄较大的成年人患喉神经复发损伤的几率更高 (OR,1.58),血液瘤 (OR,2.32) 和死亡率 (OR,11.09).
- 在不同年龄组中,低血症和伤口并发症的发生率相似.
结论:
- 甲状腺切除术在老年患者中通常是安全的.
- 特定并发症风险的微小绝对增加值得考虑.
- 研究结果支持对接受甲状腺切除术的老年患者进行个性化咨询和术后护理.
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