1、中国病案2023 年第 24 卷第 2 期 43 3.2 甲状腺癌死亡趋势 统计期间，湖北地区甲状腺癌死亡者共 126 例，粗死亡率为 0.42/10 万，标准死亡率为 0.48/10 万，其中男性死亡者 57 例，女性死亡者 69 例，男女死亡比例为 1：1.21，男性甲状腺癌粗死亡率为 0.39/10 万，标化死亡率为0.44/10 万，女性粗死亡率为 0.43/10 万，标化死亡率为 0.50/10 万，女性甲状腺癌死亡率是男性的1.01 倍，无显著性差异。随着年龄的不断增加，甲状腺癌死亡率呈上升趋势，55 岁之前的死亡率均处于较低水平，5559 岁死亡率率开始快速上升，在85 岁以上达
2、到最高峰(8.69/10 万)，甲状腺癌标化发病率从 2010 年的 9.84/10 万上升至 2020 年的26.58/10 万，发病率 PC 为 114.87%，APC(95%CI)为 14.87%(11.88%-18.98%)，呈明显上升趋势。甲状腺癌标化死亡率从2010年的0.43/10万上升到2020 年的 0.63/10 万，死亡 PC 为 6.23%，APC(95%CI)为 6.23%(4.55%-8.74%)，而不同性别甲状腺癌死亡情况无明显差异。综上所述，甲状腺癌发病率随时间呈上升趋势，女性发病率高于男性，不同性别发病高峰年龄段间存在差异，但甲状腺癌死亡率随时间无明显改变。建
3、议临床以中老年女性为重点干预对象，加强甲状腺癌筛查，做到早发现、早诊断、早治疗，降低死亡风险，提高生命质量。参考文献 1 Roman BR,Morris LG,Davies L.The thyroid cancer epidemic,2017 perspectiveJ.Current opinion in endocrinology,diabetes,and obesity,2017,24(5):332-336.2 Seib CD,Sosa JA.Evolving Understanding of the Epidemiology of Thyroid CancerJ.Endocrinolog
4、y and metabolism clinics of North America,2019,48(1):23-35.3 Grani G,Lamartina L,Durante C,et al.Follicular thyroid cancer and Hrthle cell carcinoma:challenges in diagnosis,treatment,and clinical managementJ.The lancet.Diabetes&endocrinology,2018,6(6):500-514.4 张光耀,郭伟,朱奕潼,等.20092015 年甘肃省肿瘤登记地区甲状腺癌流行
5、特征及变化趋势J.实用肿瘤学杂志,2021,35(3):218-223.5 韩婧,康骅.甲状腺癌的发病现状及影响因素J.实用预防医学,2018,25(7):894-897.6 杨雷,郑荣寿,王宁,等.2013 年中国甲状腺癌发病与死亡情况J.中华肿瘤杂志,2017,39(11):862-867.7 McLeod DSA,Zhang L,Durante C,et al.Contemporary Debates in Adult Papillary Thyroid Cancer ManagementJ.Endocrine reviews,2019,40(6):1481-1499.8 Deng Y,
6、Li H,Wang M,et al.Global Burden of Thyroid Cancer From 1990 to 2017J.AMA network open,2020,3(6):e208759.9 沈秋明,王洁,李卓颖,等.上海市长宁区甲状腺癌发病率时间趋势分析J.中国公共卫生,2021,37(4):706-709.10 丛舒,方利文,包鹤龄,等.1990年与2013年中国人群甲状腺癌疾病负担分析J.中华流行病学杂志,2016,37(6):773-777.11 Jackson D,Handelsman RS,Farr JC,et al.Increased Incidental T
7、hyroid Cancer in Patients With Subclinical Chronic Lymphocytic ThyroiditisJ.Journal of surgical research,2020,245:115-118.12 Kitahara CM,K RmendinFarkas D,Jrgensen JOL,et al.Benign Thyroid Diseases and Risk of Thyroid Cancer:A Nationwide Cohort StudyJ.Journal of clinical endocrinology and metabolism
8、,2018,103(6):2216-2224.13 Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cance
9、rJ.Thyroid,2016,26(1):1-133.14 Haugen BR.2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer:What is new and what has changed?J Cancer,2017,123(3):372-381.15 闫蓓,杨黎明,杨琛,等.上海市浦东新区 2002-2009 年甲状腺癌发病情况的趋势分析J.肿瘤,2012,32(12):987
10、-991.(2022-03-21 收稿)医务人员对肿瘤随访工作的认知 田 国 徐小莉 李书梅*摘要 目的 探讨医务人员对于肿瘤随访工作的认知，加强随访的重视与利用。方法 2019 年 9 月 1 日-2019 年 9 月 30 日采用问卷调查的方法分析不同职能、职称、科室的 1160 名医务人员对肿瘤随访工作的认知情况。结果 488 名医务人员参与过随访工作，包括 69.8%的医师和 27.3%的护士。正高级医务人员参与随访工作比例最大为 88.9%。776 名医务人员对随访工作有一定的了解，包括 83.9%的医师和 57.6%的护士。正高级医务人员对随访工作了解的比例最高为 93.3%。11
11、33 名医务人员认可随访工作的重要性，占总人数的 97.7%。75.5%的医务人员需要进行随访工作，医师比例最高为 94%，技师比例最低为 54.2%。776名医务人员选择在医院的随访中心进行随访，包括 76.1%的医师，排所有医务人员中第二位，仅次于科研人员，护士比例为最低为 58.8%。临床科室选择随访中心的比例普遍不高。结论 大多数医务人员肯定了随访工作的重要性，但缺乏深刻的认识，应加强随访工作的宣传和推广，不断完善随访管理系统，使其更好地服务于医务人员。关键词 肿瘤随访；随访系统；医务人员；认知 基金项目：河北省医学科学研究重点课题计划(20170755)河北医科大学第四医院病案室，河
12、北省，石家庄市，050000*通信作者 中国病案2023 年第 24 卷第 2 期 44 Investigation on theInvestigation on the Cognition of Conducting FollowCognition of Conducting Follow-up Studies on Cancerous Tumor Cases to Medical Staffup Studies on Cancerous Tumor Cases to Medical Staff Tian Guo,Xu Xiaoli,Li Shumei*AbstractAbstract Ob
13、jectivesObjectives To investigate the cognition of the conducting follow-up studies on cancerous tumor cases to medical staff,and strengthen the attention and utilization of follow-up.MethodsMethods From September 1st,2019 to September 30th,2019,questionnaire survey was randomly distributed to 1,160
14、 medical staff of Hebei Tumor Hospital and the results of the questionnaire were statistically described and analyzed to discuss the cognition of tumor follow-up among medical staff with different functions(doctor,nurse,technician,etc.),professional titles(primary,middle,vice-senior,senior,etc.)and
15、departments(surgery department,medical department,examinational department,etc.).Results Results 488 medical staff participated in the follow-up work,including 69.8%of doctors and 27.3%of nurses.The proportion of senior medical staff participating in the follow-up work was 88.9%.776 medical staff ha
16、d some understanding of the follow-up work,including 83.9%of doctors and 57.6%of nurses.The proportion of senior medical staff to understand the follow-up work was the highest(93.3%).1133 medical staff with different functions,professional titles and departments all recognized the importance of follow-up,accounting for 97.7%of the total number.75.5%of the medical staff needed to follow up tumor patients,with the highest proportion of doctors(94%)and the lowest proportion of technicians(54.2%).77