Canadian clinical practice guidelines for acute and chronic rhinosinusitis.
Canadian clinical practice guidelines for acute and chronic rhinosinusitis.
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DOI：
10.1186/1710-1492-7-2
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发表时间：
2011-02-10
期刊：
影响因子：
--
通讯作者：
Witterick IJ
中科院分区：
文献类型：
--
作者：
Desrosiers M;Evans GA;Keith PK;Wright ED;Kaplan A;Bouchard J;Ciavarella A;Doyle PW;Javer AR;Leith ES;Mukherji A;Schellenberg RR;Small P;Witterick IJ
本文件为医疗保健从业者提供了有关急性鼻窦炎 (ARS) 和慢性鼻窦炎 (CRS) 管理的信息，使他们能够更好地满足该患者群体的需求。这些指南描述了急性细菌性鼻窦炎 (ABRS) 治疗中的争议，并包括考虑细菌学状况变化的建议。美国和欧洲团体于 2007 年发布了最新的 ABRS 指南，但这些指南要么仅限于 CRS 主题的覆盖范围，要么不遵循基于证据的策略，要么在指南制定中忽略了相关利益相关者，并且没有解决加拿大医疗保健环境的具体情况。对 CRS 病理生理学了解的进展以及适当治疗策略的开发改善了 CRS 患者的预后。 CRS 现在影响着全球大量患者，初级保健医生每天都会遇到这种疾病。尽管最初认为 CRS 是一种慢性细菌感染，但现在认为 CRS 具有多种不同的成分（例如感染、炎症），这导致治疗方法发生变化（例如增加皮质类固醇的使用）。细菌在慢性感染持续存在中的作用以及手术和医疗管理的作用正在不断发展。尽管证据有限，但治疗 CRS 患者的指南将帮助在该领域经验不足的从业者提供合理的护理。将 CRS 作为 ARS 的延长版本进行管理已不再合理，而是必须开发和推广适合发病机制的特定治疗策略。指南必须考虑所有可用的证据，并根据证据的质量、治疗效果和风险，以公正的方式将这些证据纳入管理建议中。本文件注重可读性而不是完整性，但涵盖了相关信息，对存在大量证据的领域进行了总结，并提供了建议，并对证据基础的强度和准备该文件的多学科专家组的认可程度进行了评估。这些指南已在《过敏、哮喘和临床免疫学》和《耳鼻喉头颈外科杂志》上共同发表。
This document provides healthcare practitioners with information regarding the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) to enable them to better meet the needs of this patient population. These guidelines describe controversies in the management of acute bacterial rhinosinusitis (ABRS) and include recommendations that take into account changes in the bacteriologic landscape. Recent guidelines in ABRS have been released by American and European groups as recently as 2007, but these are either limited in their coverage of the subject of CRS, do not follow an evidence-based strategy, or omit relevant stakeholders in guidelines development, and do not address the particulars of the Canadian healthcare environment. Advances in understanding the pathophysiology of CRS, along with the development of appropriate therapeutic strategies, have improved outcomes for patients with CRS. CRS now affects large numbers of patients globally and primary care practitioners are confronted by this disease on a daily basis. Although initially considered a chronic bacterial infection, CRS is now recognized as having multiple distinct components (eg, infection, inflammation), which have led to changes in therapeutic approaches (eg, increased use of corticosteroids). The role of bacteria in the persistence of chronic infections, and the roles of surgical and medical management are evolving. Although evidence is limited, guidance for managing patients with CRS would help practitioners less experienced in this area offer rational care. It is no longer reasonable to manage CRS as a prolonged version of ARS, but rather, specific therapeutic strategies adapted to pathogenesis must be developed and diffused. Guidelines must take into account all available evidence and incorporate these in an unbiased fashion into management recommendations based on the quality of evidence, therapeutic benefit, and risks incurred. This document is focused on readability rather than completeness, yet covers relevant information, offers summaries of areas where considerable evidence exists, and provides recommendations with an assessment of strength of the evidence base and degree of endorsement by the multidisciplinary expert group preparing the document. These guidelines have been copublished in both Allergy, Asthma & Clinical Immunology and the Journal of Otolaryngology-Head and Neck Surgery.
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影响因子：
4.6
作者：
Alho, OP;Karttunen, R;Karttunen, TJ
通讯作者：
Karttunen, TJ
影响因子：
2.6
作者：
AXELSSON, A;BRORSON, JE
通讯作者：
BRORSON, JE
影响因子：
39.2
作者：
Barkun, A;Bardou, M;Marshall, JK
通讯作者：
Marshall, JK
影响因子：
2.5
作者：
Arrieta, Jose R.;Galgano, Alejandro S.;Torres, Arturo
通讯作者：
Torres, Arturo
DOI：
10.1016/j.diagmicrobio.2008.01.010
发表时间：
2008-05-01
影响因子：
2.9
作者：
Ambrose, Paul G.;Anon, Jack B.;Drusano, George L.
通讯作者：
Drusano, George L.