van Lieshout J, Wessels P, van Rijswijk E, Boer A M, Wiersma A, Goudswaard A N
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.
Ned Tijdschr Geneeskd. 2007 Dec 22;151(51):2829-32.
--The practice guideline 'Thyroid disorders' developed by the Dutch College of General Practitioners replaces the practice guideline 'Functional thyroid disorders' from 1996. Recommendations for palpable thyroid disorders have been added. --Hypothyroidism can often be treated by the general practitioner. The guideline offers specific recommendations for substitution therapy based on the 'start low, go slow'-principle. --Pharmacological treatment of hyperthyroidism is described as an optional activity for general practitioners. --A conservative approach is taken to the treatment of subclinical thyroid dysfunction. The development of symptoms may justify treatment initiation. --Cooperation has improved harmonisation of this practice guideline with the Netherlands Association for Internal Medicine's practice guideline 'Functional thyroid disorders' and the Dutch Institute for Healthcare Improvement's practice guideline 'Thyroid carcinomas'.
——荷兰全科医生学院制定的“甲状腺疾病”实践指南取代了1996年的“功能性甲状腺疾病”实践指南。增加了对可触及甲状腺疾病的建议。
——甲状腺功能减退通常可由全科医生治疗。该指南基于“起始剂量低,增量缓慢”原则提供了替代疗法的具体建议。
——甲状腺功能亢进的药物治疗被描述为全科医生的一项可选活动。
——对亚临床甲状腺功能障碍采取保守治疗方法。症状的出现可能说明需要开始治疗。
——通过合作,该实践指南与荷兰内科协会的“功能性甲状腺疾病”实践指南以及荷兰医疗保健改善研究所的“甲状腺癌”实践指南的协调性得到了提高。