摘要
目的:探讨围手术期中西医结合治疗对老年甲状腺疾病辅助治疗的作用。方法:对368例60岁以上的老年甲状腺疾病患者,针对并发的各种老年疾病,加强围手术期处理,术前舌下含服硝酸甘油减少心脏负荷,降低心肌的耗氧量。所有老年患者在常规术前护理的基础上予中药"八珍汤"加减补益气血,并加强术前肺功能锻炼等,针对各种老年人常见并发症予中西医结合对症治疗,稳定的情况下行甲状腺手术,正确处理术后不适,防止术后并发症。结果:所有患者无手术死亡,术中气管痉挛3例,术后发生短期手足抽搦6例,呛咳2例,肺部感染5例,喉上神经内侧支损伤2例,无喉返神经损伤,无术后出血。全组未出现甲亢危象。随访1～3年,出现甲状腺功能低下4例,无甲亢复发。患者平均住院时间短(15.2 d),甲状腺良性疾病治愈率达100%,恶性肿瘤3年生存率达90%。结论:采用中西医结合方法加强围手术期处理,可以提高甲状腺手术的成功率,减少术后并发症,降低手术风险。
Objective：To explore the effect of the perioperative integrative medicine in elderly patients with thyroid disease. Meth- ods： 368 cases of over 60 elderly patients with thyroid disease, for concurrent age-related diseases, were treated with strengthened perioperative management of the preoperative sublingual nitroglycerin to reduce cardiac preload and afterload and decrease myocardial oxygen consumption ; added with ＂Bazhen soup＂ ; strengthening exercise for the preoperative pulmonary function and eontroling a varie- ty of complications for the stability of the downstream thyroid surgery. Results： There were no operative deaths, 4 cases of transient thyroid dysfunction, 2 cases of nerve damage, 6 cases of convulsions, no postoperative bleeding, 5 cases of postoperative lung infec- tion, shorter hospital stay （mean 15.2d） , rapid postoperative recovery, follow-up of 351 cases, of which 100% cure rate of patients with benign thyroid disease, malignant tumors 3-years survival rate 90%. Conclusion： Perioperative period of Integrative Medicine is safe for the purpose of thyroid surgery in elderly patients with thyroid disease.
出处
《川北医学院学报》
CAS
2013年第3期269-272,共4页
Journal of North Sichuan Medical College
关键词
甲状腺疾病
老年患者
围手术期
中西医结合治疗
Thyroid disease
Elderly patients
Perioperative
Combining traditional Chinese and western medicine treatment
