Brothers T E, Thompson N W
Acta Chir Scand. 1987 Mar;153(3):175-8.
Surgical treatment of hyperparathyroidism is often withheld from elderly patients out of concern about operative morbidity and mortality. We reviewed the case records of 81 patients over the age of 65 who underwent neck exploration for primary hyperparathyroidism at the University of Michigan Medical Center during the past 10 years. The most common presenting symptoms were lethargy (62%), neurological complaints (44%), and constipation (42%). Less common were histories of peptic ulcer disease (30%) and renal lithiasis (25%). Delay from time of diagnosis to operation averaged 33 weeks. Seventy-seven percent had adenomas, of which 9% were multiple. Average postoperative hospital stay was 7.1 days, ranging from 3 to 22 days. There was no mortality. We believe that neck exploration for primary hyperparathyroidism can be safely performed in elderly patients and should not be delayed or withheld merely on the basis of advanced age.
由于担心手术并发症和死亡率，老年患者常不接受甲状旁腺功能亢进症的手术治疗。我们回顾了过去10年在密歇根大学医学中心接受颈部探查以治疗原发性甲状旁腺功能亢进症的81例65岁以上患者的病例记录。最常见的症状是嗜睡（62%）、神经症状（44%）和便秘（42%）。较少见的是消化性溃疡病史（30%）和肾石症病史（25%）。从诊断到手术的平均延迟时间为33周。77%的患者患有腺瘤，其中9%为多发性腺瘤。术后平均住院时间为7.1天，范围为3至22天。无死亡病例。我们认为，对于老年患者，原发性甲状旁腺功能亢进症的颈部探查可以安全地进行，不应仅仅因为年龄较大而延迟或不进行手术。
