Reis Abílio, Rocha Nelson, Barros Rui, Martins Alfredo, Oliveira Filomena, Diogo António Nunes, da Silva António Marinho, Alvares Silvia, Shiang Teresa, Castro Graça, Agapito Ana
Núcleo de Estudos de Doença Vascular Pulmonar da Sociedade Portuguesa de Medicina Interna, Lisboa, Portugal.
Rev Port Cardiol. 2010 Feb;29(2):253-89.
Pulmonary hypertension (PH) was until recently an obscure pathology which frequently went unidentified as it lacked a precise diagnostic strategy. Recent years have seen advances in the knowledge of the pathogenesis and mechanisms of vascular lesion of PH. This has led to the scientific community's growing interest in this area, an interest manifested in appreciable progress in the pathology's clinical characterisation, diagnostic strategies and the development of effective drugs. All of this together has been fundamental in changing the previously unfavourable prognosis of this disease. This evolution implies the need to rationalise the use of available resources through organisation of healthcare services, defining the role of each level of care, and developing norms for good clinical management practices in keeping with best medical practice guidelines. These twin aspects have attracted the interest of the scientific community, as shown by the wealth of literature, and have led healthcare authorities to introduce regulatory mechanisms. In order to improve clinical practice, the Pulmonary Vascular Disease Study Group (NEDVP) of the Portuguese Society of Internal Medicine (SPMI), the Pulmonary Hypertension Study Group (GEHTP) of the Portuguese Society of Cardiology and the boards of the Portuguese Societies of Pulmonology and Paediatric Cardiology created an interdisciplinary working group. The group's remit was to draft this document, "Guidelines for the management of pulmonary hypertension patients", based on a review of the literature and the authors' clinical expertise. These guidelines aim to present all the relevant evidence on the diagnostic and treatment strategy of PH and the definition of requirements for referral centres. The organisation of care is fundamental for an appropriate and rational use of the available resources and for the better care of the patient.
直到最近，肺动脉高压（PH）仍是一种鲜为人知的病理状况，由于缺乏精确的诊断策略，常常未被识别出来。近年来，人们对PH发病机制及血管病变机制的认识有了进展。这使得科学界对该领域的兴趣日益浓厚，这种兴趣体现在该病理状况的临床特征描述、诊断策略以及有效药物研发方面取得的显著进展上。所有这些共同作用，对于改变该疾病先前不佳的预后至关重要。这种演变意味着需要通过医疗服务的组织来合理利用现有资源，明确各级医疗护理的作用，并制定符合最佳医疗实践指南的良好临床管理规范。这两个方面引起了科学界的兴趣，丰富的文献便是证明，也促使医疗管理部门引入监管机制。为了改善临床实践，葡萄牙内科协会（SPMI）的肺动脉疾病研究组（NEDVP）、葡萄牙心脏病学会的肺动脉高压研究组（GEHTP）以及葡萄牙肺科和儿科心脏病学会的理事会成立了一个跨学科工作组。该小组的职责是根据文献综述和作者的临床专业知识起草这份文件《肺动脉高压患者管理指南》。这些指南旨在呈现关于PH诊断和治疗策略以及转诊中心要求定义的所有相关证据。医疗护理的组织对于合理适当利用现有资源以及更好地照顾患者至关重要。
