1、,作者 : XXX,单位 : 南京医科大学第一附属医院,第二十二章,颈部疾病,第一节 甲状腺疾病,第二节 甲状旁腺功能亢进的外科治疗,第三节 颈淋巴结结核,第四节 颈部肿块,颈淋巴结结核,第三节,外科学（第9版）,一、概述,多见于儿童和青年人 结核杆菌经扁桃体、龋齿侵入 约5%继发于肺和支气管结核病变,外科学（第9版）,二、临床表现,淋巴结肿大 淋巴结周围炎 结节性肿块 寒性脓肿、慢性窦道与溃疡,局部症状,全身症状,低热 盗汗 食欲缺乏 消瘦,外科学（第9版）,外科学（第9版）,三、诊断,结核病接触史 局部体征,必要时细针穿刺,外科学（第9版）,四、治疗,全身治疗为主,局部治疗：穿刺抽吸、切开
2、引流,颈部包块,第四节,外科学（第9版）,一、概述,颈部肿块 颈部疾病,外科学（第9版）,二、颈部包块鉴别诊断,炎症？ 先天性畸形？ 肿瘤（原发、转移）？,外科学（第9版）,外科学（第9版）,外科学（第9版）,颈部解剖分区,颈部包块鉴别,外科学（第9版）,转移性肿瘤,85%原发在头颈部 鼻咽癌/甲状腺癌 锁骨上窝 多在胸腹部 左锁骨上淋巴结 胃肠道、胰腺癌肿 经胸导管,三、常见颈部肿块,外科学（第9版）,外科学（第9版）,外科学（第9版）,推荐参考教材,Sabiston Textbook of Surgery, 20th, 2016 Schwartzs Principles of Surger
3、y, 10th,2015 Maingots Abdominal Operations, 12th,2013 Current Surgical Therapy, 11th,2014 Essential Surgery Problems Diagnosis and Management, 5th,2014 Common Surgical Diseases, An Algorithmic Approach to Problem Solving, 3rd, 2015,Sabiston Textbook of Surgery, 20th, 2016 Schwartzs Principles of Surgery, 10th,2015 Maingots Abdominal Operations, 12th,2013 Current Surgical Therapy, 11th,2014 Essential Surgery Problems Diagnosis and Management, 5th,2014 Common Surgical Diseases, An Algorithmic Approach to Problem Solving, 3rd, 2015,
