肝硬化腹水管理指南

StephenW

Guidelines on the management of ascites in cirrhosis

    http://orcid.org/0000-0003-3924-4830Guruprasad P Aithal1,2, Naaventhan Palaniyappan1,2, Louise China3, Suvi Härmälä4, http://orcid.org/0000-0003-4324-0138Lucia Macken5,6, Jennifer M Ryan3,7, Emilie A Wilkes2,8, Kevin Moore3, Joanna A Leithead9, Peter C Hayes10, http://orcid.org/0000-0002-9168-7009Alastair J O'Brien3, Sumita Verma5,6

Author affiliations

    NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK
    Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
    Institute of Liver Disease and Digestive Health, University College London, London, UK
    Institute of Health Informatics, University College London, London, UK
    Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
    Department of Gastroenterology and Hepatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
    Royal Free London NHS Foundation Trust, London, UK
    Nottingham University Hospitals NHS Trust, Nottingham, UK
    Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
    Hepatology Department, Royal Infirmary of Edinburgh, Edinburgh, UK

    Correspondence to Professor Guruprasad P Aithal, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK; [email protected]

Abstract

The British Society of Gastroenterology in collaboration with British Association for the Study of the Liver has prepared this document. The aim of this guideline is to review and summarise the evidence that guides clinical diagnosis and management of ascites in patients with cirrhosis. Substantial advances have been made in this area since the publication of the last guideline in 2007. These guidelines are based on a comprehensive literature search and comprise systematic reviews in the key areas, including the diagnostic tests, diuretic use, therapeutic paracentesis, use of albumin, transjugular intrahepatic portosystemic stent shunt, spontaneous bacterial peritonitis and beta-blockers in patients with ascites. Where recent systematic reviews and meta-analysis are available, these have been updated with additional studies. In addition, the results of prospective and retrospective studies, evidence obtained from expert committee reports and, in some instances, reports from case series have been included. Where possible, judgement has been made on the quality of information used to generate the guidelines and the specific recommendations have been made according to the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE)’ system. These guidelines are intended to inform practising clinicians, and it is expected that these guidelines will be revised in 3 years’ time.
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http://dx.doi.org/10.1136/gutjnl-2020-321790

StephenW

肝硬化腹水管理指南

    http://orcid.org/0000-0003-3924-4830Guruprasad P Aithal1,2，Naaventhan Palaniyappan1,2，Louise China3，SuviHärmälä4，http：//orcid.org/0000-0003-4324-0138Lucia Macken5,6，珍妮弗·瑞安（Jennifer M Ryan）3,7，埃米莉·威尔克斯（Emilie A Wilkes）2,8，凯文·摩尔（Kevin Moore3），乔安娜·阿莱特黑德（Joanna A Leithead）9，彼得·C·海斯（Peter C Hayes）10，http://orcid.org/0000-0002-9168-7009Alastair J O'Brien3，Sumita Verma5,6

作者单位

    NIHR诺丁汉生物医学研究中心，诺丁汉大学医院NHS Trust和英国诺丁汉的诺丁汉大学
    英国诺丁汉诺丁汉大学医学院诺丁汉消化系统疾病中心
    英国伦敦大学学院肝病与消化健康研究所
    英国伦敦大学学院健康信息学研究所
    英国布莱顿布赖顿与苏塞克斯医学院临床与实验医学系
    英国布莱顿布莱斯和萨塞克斯大学医院NHS基金会胃肠病学和肝病学系
    英国伦敦皇家免费NHS基金会信托
    英国诺丁汉诺丁汉大学医院NHS Trust
    剑桥大学医院NHS基金会信托基金肝单位，英国剑桥
    英国爱丁堡爱丁堡皇家医院肝脏科

    与英国诺丁汉大学医院NHS Trust的NIHR诺丁汉生物医学研究中心的Guruprasad P Aithal教授以及英国诺丁汉NG7 2UH的诺丁汉大学的对应关系； [email protected]

抽象

英国胃肠病学会与英国肝脏研究协会合作编写了该文件。本指南的目的是回顾和总结指导肝硬化患者腹水临床诊断和处理的证据。自从2007年发布最新指南以来，该领域取得了实质性进展。这些指南基于全面的文献检索，包括对关键领域的系统评价，包括诊断测试，利尿剂使用，治疗性穿刺，白蛋白的使用，腹水患者的经颈静脉肝内门系统支架分流术，自发性细菌性腹膜炎和β受体阻滞剂。如果有最新的系统评价和荟萃分析，这些将通过其他研究得到更新。此外，还包括前瞻性和回顾性研究的结果，从专家委员会的报告中获得的证据，在某些情况下还包括病例系列的报告。在可能的情况下，已对用于生成准则的信息质量进行了判断，并根据“建议评估，发展和评估等级（GRADE）”系统制定了具体建议。这些准则旨在为临床医生提供信息，预计这些准则将在3年后进行修订。
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http://dx.doi.org/10.1136/gutjnl-2020-321790

StephenW

https://gut.bmj.com/content/earl ... nl-2020-321790.full