德尔菲达成共识声明,用于治疗多斑切除术后延迟出血的治疗
Enrique Rodríguez de Santiago1,2, Sandra Pérez de la Iglesia1, Diego de Frutos3
1Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Therapeutic advances in gastroenterology
|April 29, 2025
概括
术后延迟出血 (DPPB) 的管理不一致. 这一共识提供了基于证据的指导方针,以标准化护理,减少不必要的程序,并改善这种常见的结肠镜复杂症的患者结果.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 干预性放射学 干预性放射学
背景情况:
- 透析术后延迟出血 (DPPB) 是结肠透析术后最常见的并发症.
- 目前DPPB的管理策略缺乏标准化,导致异质的临床实践.
- 许多针对DPPB进行的结肠镜检查是不必要的,并且不会导致静血干预.
研究的目的:
- 建立基于证据的陈述,以指导DPPB管理中的临床决策.
- 开发一个标准化的框架来解决这种常见的多重切除术后的并发症.
主要方法:
- 这是一个多学科的德尔菲共识过程,涉及胃肠病学,血液学,放射学和外科手术的29名专家.
- 系统的文献审查,其次是反复的匿名投票和反.
- 在声明上达成共识,达成80%的同意.
主要成果:
- 开发了36个共识声明,涉及抗血栓治疗,肠道准备,结肠镜指示和静血技术.
- 关键建议包括管理自我限制的出血,不必要的结肠镜检查的风险分层,以及不稳定的患者的血管栓塞.
- 为DPPB管理提出了一种实际的临床算法.
结论:
- 这种共识为标准化DPPB管理提供了一个框架.
- 建议旨在提高患者的治疗成果,并优化医疗保健资源的利用.
- 促进对DPPB的标准化方法对于提高护理质量至关重要.
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