免疫性血小板减少症的临床指南更新：ASH循证指南
2011-03-03 00:00:00来源：医脉通阅读：43次
期刊影响因子：10.556
免疫血小板减少症(ITP) 是临床诊疗中的一种常见病。1996年美国血液学学会发表了具有里程碑意义的指南文章，旨在协助临床医生治疗该病。自1996年以来，成人及儿童ITP的治疗已取得了众多进展。这些变化促使指南的更新。本指南采用严格的循证方法来查找、解释和呈现可获得的证据。我们采用严谨的方法，努力鉴别、提炼并呈现所有可获得的数据，其中包括ITP的治疗信息。在证据存在的领域我们应用GRADE系统提供循证治疗指南。在证据缺乏或质量低的领域，我们不提供证据；感兴趣的读者可参考这些临床领域专家近期达成的共识。我们的回顾证实了在ITP治疗的许多关键领域尚需进一步的研究，如ITP“一线”治疗的比较研究、ITP患者严重出血的处理以及针对一线治疗失败后采取何种补救疗法而提供指南的研究。
医脉通推荐英文摘要
Blood，2011.2.16
Clinical guideline update on "Immune thrombocytopenia: an evidence based practice guideline developed by the American Society of Hematology"
Cindy Neunert1, Wendy Lim2, Mark Crowther3,
（University of Texas, Southwestern Medical Center, Dallas, TX, United States）
Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation and presentation of the available evidence. We have endeavored to identify, abstract and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality – interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP and studies which will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first line intervention.
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