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《2007AASLD/ACG肝硬化食管胃底靜脈曲張和靜脈曲張出血的預(yù)防和管理》內(nèi)容預(yù)覽

These recommendations provide a data-supported ap-proach to the management of patients with varices and variceal hemorrhage. They are based on the following: (1) formal review and analysis of the recently published world literature on the topic (Medline search); (2) several con-sensus conferences among experts; (3) the American Col-lege of Physicians’ Manual for Assessing Health Practices and Designing Practice Guidelines  guideline policies,

including the American Association for the Study of Liver Diseases’ Policy Statement on Development and Use of Practice Guidelines and the American Gastroenterologi-cal Association’s Policy Statement on the Use of Medical Practice Guidelines and (5) the authors’ years of experi-ence caring for patients with cirrhosis and varices. Intended for use by healthcare providers, these recom-mendations suggest preferred approaches to the diagnos-tic, therapeutic, and preventive aspects of care. As with other practice guidelines, this guideline is not intended to replace clinical judgment but rather to provide general guidelines applicable to the majority of patients. They are intended to be flexible, in contrast to standards of care, which are inflexible policies designed to be followed in every case. Specific recommendations are based on rele-vant published information. To more fully characterize the quality of evidence supporting recommendations, the Practice Guidelines Committee of the AASLD requires a class (reflecting benefit versus risk) and level (assessing strength or certainty) of evidence to be assigned and re-ported with each recommendation Table 1, adapted from the American College of Cardiology and the Amer-ican Heart Association Practice Guidelines

When little or no data exist from well-designed pro-spective trials, emphasis is given to results from large series and reports from recognized experts. Further controlled clin-ical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical con-siderations may justify a course of action that differs from these recommendations. These recommendations are fully endorsed by the American Association for the Study of Liver Diseases and the American College of Gastroenterology.

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