European Position Paper on Rhinosinusitis and Nasal Polyps 2020
European Position Paper on Rhinosinusitis and Nasal Polyps 2020
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DOI：
10.4193/rhin20.600
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发表时间：
2020-02-01
期刊：
影响因子：
7.2
通讯作者：
Zwetsloot, Casper P.
中科院分区：
文献类型：
--
作者：
Fokkens, Wytske J.;Lund, Valerie J.;Zwetsloot, Casper P.
《2020年欧洲鼻窦炎和鼻息肉立场文件》是对2005年、2007年和2012年发表的类似循证立场文件的更新。EPOS 2020指南的核心目标是为ARS和CRS提供修订的、最新的和明确的循证建议和综合护理途径。EPOS 2020提供了自EPOS 2012立场文件发表以来八年内发表的文献和开展的研究的更新，并解决了EPOS 2012中未广泛涵盖的领域，如儿科CRS和鼻窦手术。EPOS 2020还涉及新的利益相关者，包括药剂师和患者，并解决了自上一份EPOS文件发布以来更多参与鼻窦炎管理和治疗的新目标用户，包括药剂师，护士，专业护理人员以及患者本身，他们使用非处方治疗来增加自我管理病情。该文件为该领域的未来研究提供了建议，并为不同环境下的研究定义和结果测量提供了最新的指导。EPOS 2020包含有关定义和分类的章节，我们定义了大量术语并指出了首选术语。根据解剖学分布，提出了CRS的新分类，分为原发性和继发性CRS，并进一步分为局限性和弥漫性疾病。有广泛的章节流行病学和诱发因素，炎症机制，（鉴别）诊断面部疼痛，过敏性鼻炎，遗传学，囊性纤维化，阿司匹林加剧呼吸道疾病，免疫缺陷，过敏性真菌性鼻窦炎和上下气道之间的关系。关于儿科急性和慢性鼻窦炎的章节完全重写。所有可用的证据急性鼻窦炎和慢性鼻窦炎伴或不伴鼻息肉的成人和儿童的管理系统审查和综合护理途径的证据的基础上提出。尽管近年来高质量的出版物数量大幅增加，但仍存在大量实际的临床问题。与会者一致认为，解决这些问题的最佳办法是进行一次德尔菲调查。有关结果已纳入有关章节。最后但并非最不重要的是，包括对患者和药剂师的建议以及新的研究需求清单。
The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings.EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.