The role of endoscopy in the patient with lower GI bleeding
The role of endoscopy in the patient with lower GI bleeding
复制标题
DOI：
10.1016/j.gie.2013.10.039
复制
发表时间：
2014-06-01
影响因子：
7.7
通讯作者：
Cash, Brooks D.
中科院分区：
文献类型：
--
作者：
Pasha, Shabana F.;Shergill, Amandeep;Cash, Brooks D.
这是讨论胃肠道内窥镜检查在常见临床情况下的使用的一系列声明之一。本文本由美国胃肠内窥镜学会 (ASGE) 实践标准委员会编写。在准备本文件时，使用 PubMed 检索了 1990 年 1 月至 2013 年 3 月期间发表的与该主题相关的医学文献。其他参考文献是从已确定文章的参考书目和专家顾问的建议中获得的。当精心设计的前瞻性试验的数据很少或没有时，重点是大型系列的结果和知名专家的报告。适当使用内窥镜检查的建议是基于对现有数据的严格审查和起草文件时的专家共识。可能需要进一步的对照临床研究来澄清本文件的各个方面。本文件是对先前 ASGE 关于此主题的指南的更新审查。 1,2 本文件可能会根据需要进行修订，以考虑技术、新数据或临床实践其他方面的变化。这些建议基于经过审查的研究，并根据支持证据的强度进行分级3（表 1）。个人建议的强度取决于总体证据质量以及对预期利益和危害的评估。较弱的建议由“我们建议”等短语表示。而更强烈的建议通常表述为“我们建议......”。本文件旨在成为一种教育工具，提供可以帮助内窥镜医生为患者提供护理的信息。它不是一条规则，也不应被解释为建立法律护理标准或鼓励、提倡、要求或阻止任何特定治疗。任何特定病例的临床决策都涉及对患者病情和可用行动方案的复杂分析。因此，临床考虑可能会导致内窥镜医师采取与这些建议不同的行动方案。
This is one of a series of statements discussing the use of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text. In preparing this document, a search of the medical literature pertaining to this topic published between January 1990-March 2013 was performed by using PubMed. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When few or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Recommendations for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time that the documents are drafted. Further controlled clinical studies may be needed to clarify aspects of this document. This document represents an updated review of previous ASGE guidance on this topic. 1,2 This document may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice. The recommendations are based on reviewed studies and are graded on the strength of the supporting evidence3 (Table 1). The strength of individual recommendations is based on both the aggregate evidence quality and an assessment of the anticipated benefits and harms. Weaker recommendations are indicated by phrases such as "We suggest." whereas stronger recommendations are typically stated as " We recommend... ."This document is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. It is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient's condition and available courses of action. Therefore, clinical considerations may lead an endoscopist to take a course of action that varies from these recommendations.