普外科诊疗规范（全套完整版）

目 录 TOC \o "1-3" \h \z \u HYPERLINK \l "_Toc248216544" 结节性甲状腺肿诊疗规范 PAGEREF _Toc248216544 \h 1 HYPE

目录 结节性甲状腺肿诊疗规范 ·································· 1 甲状腺腺瘤 ········································ 2 甲状腺功能亢进诊疗规范 ·································· 3 甲状腺癌 ········································· 5 胆囊结石(或合并胆囊炎) ·································· 6 胆囊息肉 ········································· 7 肝内、外胆管结石(或合并急性胆管炎) ···························· 8 胆管癌 ·········································· 9 急性阑尾炎 ········································ 10 腹股沟斜疝 ········································ 11 急性胰腺炎 ········································ 12 结肠癌 ·········································· 14 直肠癌 ·········································· 15 乳腺癌 ·········································· 16 原发性肝癌 ········································ 17 肠梗阻 ·········································· 19 胃癌 ··········································· 21 结节性甲状腺肿诊疗规范 概述 【】 单纯性甲状腺肿是以缺碘为主的代偿性甲状腺肿大。常见于居住在离海较远的山区，又称地方性甲状 腺肿，在非流行地区也有散在发病。患者女性多于男性，大多自青少年时期发病。 【诊断要点】 1.症状：颈前肿物病史。 2.体征：多无意中发现颈前肿物，查体在一侧或双侧甲状腺可扪及多个（或单个）结节，质地柔软， 随吞咽上下移动。 3.辅助检查：甲状腺超声：一侧或双侧甲状腺内多发囊/实性结节，并可明确甲状腺结节的数目及位置。 诊断依据 【】 1.症状：颈前肿物病史。 2.体征：多无意中发现颈前肿物，查体在一侧或双侧甲状腺可扪及多个（或单个）结节，质地柔软， 随吞咽上下移动。 3.辅助检查：甲状腺超声：一侧或双侧甲状腺内多发囊/实性结节，并可明确甲状腺结节的数目及位置。 鉴别诊断 【】 1.甲状舌管囊肿：肿物活动与吞咽活动无关,与伸舌运动关系密切。 2.甲状腺机能亢进症：临床上出现多食、消瘦、易怒等症状，甲状腺激素升高。 3.甲状腺炎：甲状腺功能改变，血清中出现甲状腺球蛋白抗体、线粒体抗体等。 1