美国肝病研究学会成人肝硬化腹水处理指南

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1、美国肝病研究学会成人肝硬化腹水处理指南（中英文对照）ManagementofAdultPatientswithAscitesDuetoCirrhosis:AnUpdatePreambleThisguidelinehasbeenapprovedbytheAASLDandrepresentsthepositionoftheAssociation.Theserecommendationsprovideadata-supportedapproach.Theyarebasedonthefollowing:(1)formalreviewandanalysisoftherecently-

2、publishedworldliteratureonthetopic(Medlinesearch);(2)AmericanCollegeofPhysiciansManualforAssessingHealthPracticesandDesigningPracticeGuidelines1;(3)guidelinepolicies,includingtheAASLDPolicyontheDevelopmentandUseofPracticeGuidelinesandtheAmericanGastroenterologicalAssociationPolicyStatement

3、onGuidelines2;and(4)theauthor’sdecadesofexperiencecaringforpatientswithcirrhosisandascites.Intendedforusebyphysicians,theserecommendationssuggestpreferredapproachestothediagnostic,therapeutic,andpreventiveaspectsofcare.Theyareintendedtobeflexible,incontrasttostandardsofcare,whichareinflexi

4、blepoliciestobefollowedineverycase.Specificrecommendationsarebasedonrelevantpublishedinformation.Tomorefullycharacterizethequalityofevidencesupportingrecommendations,thePracticeGuidelinesCommitteeoftheAASLDrequiresaClass(reflectingbenefitversusrisk)andLevel(assessingstrengthorcertainty)ofE

5、videncetobeassignedandreportedwitheachrecommendation(Table1,adaptedfromtheAmericanCollegeofCardiologyandtheAmericanHeartAssociationPracticeGuidelines3).4Theseguidelinesweredevelopedforthecareofadultpatientswithclinicallydetectableascites.Althoughthegeneralapproachmaybeapplicabletochildren,

6、thepediatricdatabaseismuchsmallerandtheremaybeunanticipateddifferencesbetweenadultsandchildren.Patientswithascitesdetectedonlybyimagingmodalitiesbutnotyetclinicallyevidentareexcludedbecauseofthelackofpublishedinformationregardingthenaturalhistoryofthisentity.AMedlinesearchfrom1966through20

7、07wasperformed;searchtermsincludedascites,hepatorenalsyndrome,diettherapy,drugtherapy,radiotherapy,surgery,andtherapy.ThesearchinvolvedonlyarticlespublishedinEnglishandinvolvinghumans.Amanualsearchoftheauthor’sfilesandrecentabstractswasalsoperformed.Thesearchy