British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults
British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults
复制标题
DOI：
10.1136/gutjnl-2019-318484
复制
发表时间：
2019-12-01
期刊：
影响因子：
24.5
通讯作者：
Hawthorne, A. Barney
中科院分区：
文献类型：
--
作者：
Lamb, Christopher Andrew;Kennedy, Nicholas A.;Hawthorne, A. Barney
溃疡性结肠炎和克罗恩病是炎症性肠病的主要形式。两者都代表胃肠道的慢性炎症，随着时间的推移，患者之间和个体内部的炎症和症状负担表现出异质性。最佳管理依赖于临床医生与患者合作的理解和定制基于证据的干预措施。本16岁以上成人炎症性肠病管理指南由代表英国内科医生（英国胃肠病学学会）、外科医生（大不列颠和爱尔兰结肠直肠病学协会）、专科护士（皇家护理学院）、儿科医生（英国儿科胃肠病学、肝病学和营养学会）、营养师（英国饮食协会）、放射科医生（英国胃肠和腹部放射学会），全科医生（胃肠病学初级保健学会）和患者（英国克罗恩病和结肠炎）。对88247份出版物进行了系统评价，并对81名多学科临床医生和患者进行了德尔菲共识过程，以制定168项基于证据和专家意见的药物、非药物和手术干预建议，以及溃疡性结肠炎和克罗恩病管理的最佳服务提供。针对免疫抑制治疗的适应症、启动和监测、营养干预、术前、围手术期和术后管理、多学科团队的结构和功能以及初级和二级医疗之间的整合，提供了全面的最新指导。通过对溃疡性结肠炎和克罗恩病患者（包括患者、其家人和朋友）的2379份电子调查反馈，提出了20项研究重点，为未来的临床管理提供信息，并对优先级重要性进行了客观测量。
Ulcerative colitis and Crohn's disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn's and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn's disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn's disease, including patients, their families and friends.