国际专家德尔菲共识关于EUS指导式港口系统压力梯度:最佳实践和未来方向
Thomas J Wang1, Kenneth Chang2, Raymond A Rubin3
1University of Southern California, Los Angeles, CA; Brigham and Women's Hospital, Boston, MA.
概括
国际专家在内镜超声波导向端口系统压力梯度 (EUS-PPG) 测量的最佳实践上达成共识. 本指南旨在标准化准确评估肝脏和门静脉压力的技术.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 用内镜超声波引导的端口系统压力梯度 (EUS-PPG) 测量是一种评估肝脏和门静脉压力的新技术.
- 这种新兴的程序在实践中存在变化.
- 建立关于最佳实践的共识对于其广泛采用和准确应用至关重要.
研究的目的:
- 建立有关EUS-PPG测量的最佳实践的国际专家共识.
- 为EUS-PPG.定义指示,程序前协议和程序内技术.
- 确定EUS-PPG的未来研究方向.
主要方法:
- 采用了经过修改的Delphi过程,涉及一个指导委员会和47名国际专家 (高级内镜学家和肝病学家).
- 在四个领域制定了共识声明:指示,程序前协议,程序内技术和未来研究.
- 声明要求通过在线调查达成≥70%的同意,对非共识项目进行修订和重新投票.
主要成果:
- 53个声明在两轮会议后达成共识,其中79%的专家参与.
- 在临床指示方面达成了共识,包括适用于所有肝静脉压梯度 (HVPG) 指示的适用性和在前鼻状门高血压中潜在的偏好.
- EUS-PPG被认为是安全的,耐受性良好,需要监控或全身麻醉,并需要精心的技术执行以确保准确性.
结论:
- 经过修改的德尔菲进程成功建立了EUS-PPG的关键方面专家协议.
- 本共识为执行EUS-PPG.提供了实际指导.
- 这些发现作为未来EUS-PPG研究的路线图.
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