一例分化型甲状腺癌患者健康管理全科医生教学案例分析

General Practitioner Health Management of a Patient with Differentiated Thyroid Cancer:a Teaching Case Study

甲状腺癌已成为北京市增长较快的恶性肿瘤。本文通过介绍1例由全科医生首诊、术后连续随访4年的分化型甲状腺癌患者的诊疗经过,采用临床案例教学方法,重点关注甲状腺结节良恶性的鉴别,全科医生接诊甲状腺结节患者的诊治流程及对甲状腺癌患者术后长期监测、健康管理的内容,引导患者规范诊治,以期为逐步实现甲状腺癌患者个体化、不同风险分层的高质量管理,提高在职全科医生、全科医学专业住院医师规范化培训的学员对甲状腺结节、分化型甲状腺癌患者的规范诊治水平,提供参考。

Thyroid cancer has a rapidly increasing prevalence in Beijing.For clinical case teaching,we reported a case of differentiated thyroid cancer with initial consultation and 4-year postsurgical follow-up services delivered by the general practitioner,with a focus on the differentiation of benign and malignant thyroid nodules,the diagnostic and therapeutic procedure of thyroid nodules,and contents of long-term postsurgical monitoring and health management,hoping to guide patients to seek healthcare in a reasonable and standardized way,and to provide a reference for gradually achieving high-quality management of thyroid cancer based on individual conditions or risk stratification,and for improving the standard management level of thyroid nodules and differentiated thyroid cancer in incumbent general practitioners and trainees receiving the standardized general practitioner residency training program.