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[《特发性肺纤维化诊断与管理的法国实用指南 - 2021年更新版,简版》]

[French practical guidelines for the diagnosis and management of IPF - 2021 update, short version].

作者信息

Cottin V, Bonniaud P, Cadranel J, Crestani B, Jouneau S, Marchand-Adam S, Nunes H, Wémeau-Stervinou L, Bergot E, Blanchard E, Borie R, Bourdin A, Chenivesse C, Clément A, Gomez E, Gondouin A, Hirschi S, Lebargy F, Marquette C-H, Montani D, Prévot G, Quetant S, Reynaud-Gaubert M, Salaun M, Sanchez O, Trumbic B, Berkani K, Brillet P-Y, Campana M, Chalabreysse L, Chatté G, Debieuvre D, Ferretti G, Fourrier J-M, Just N, Kambouchner M, Legrand B, Le Guillou F, Lhuillier J-P, Mehdaoui A, Naccache J-M, Paganon C, Rémy-Jardin M, Si-Mohamed S, Terrioux P

机构信息

Centre national coordonnateur de référence des maladies pulmonaires rares, service de pneumologie, hôpital Louis-Pradel, Hospices Civils de Lyon (HCL), Lyon, France; UMR 754, IVPC, INRAE, Université de Lyon, Université Claude-Bernard Lyon 1, Lyon, France; Membre d'OrphaLung, RespiFil, Radico-ILD2, et ERN-LUNG, Lyon, France.

Service de pneumologie et soins intensifs respiratoires, centre de référence constitutif des maladies pulmonaires rares, centre hospitalo-universitaire de Bourgogne et faculté de médecine et pharmacie, université de Bourgogne-Franche Comté, Dijon ; Inserm U123-1, Dijon, France.

出版信息

Rev Mal Respir. 2022 Mar;39(3):275-312. doi: 10.1016/j.rmr.2022.01.005. Epub 2022 Mar 15.

Abstract

BACKGROUND

Since the previous French guidelines were published in 2017, substantial additional knowledge about idiopathic pulmonary fibrosis has accumulated.

METHODS

Under the auspices of the French-speaking Learned Society of Pulmonology and at the initiative of the coordinating reference center, practical guidelines for treatment of rare pulmonary diseases have been established. They were elaborated by groups of writers, reviewers and coordinators with the help of the OrphaLung network, as well as pulmonologists with varying practice modalities, radiologists, pathologists, a general practitioner, a head nurse, and a patients' association. The method was developed according to rules entitled "Good clinical practice" in the overall framework of the "Guidelines for clinical practice" of the official French health authority (HAS), taking into account the results of an online vote using a Likert scale.

RESULTS

After analysis of the literature, 54 recommendations were formulated, improved, and validated by the working groups. The recommendations covered a wide-ranging aspects of the disease and its treatment: epidemiology, diagnostic modalities, quality criteria and interpretation of chest CT, indication and modalities of lung biopsy, etiologic workup, approach to familial disease entailing indications and modalities of genetic testing, evaluation of possible functional impairments and prognosis, indications for and use of antifibrotic therapy, lung transplantation, symptom management, comorbidities and complications, treatment of chronic respiratory failure, diagnosis and management of acute exacerbations of fibrosis.

CONCLUSION

These evidence-based guidelines are aimed at guiding the diagnosis and the management in clinical practice of idiopathic pulmonary fibrosis.

摘要

背景

自上一版法国指南于2017年发布以来,关于特发性肺纤维化又积累了大量新知识。

方法

在法语地区肺科学术协会的支持下,在协调参考中心的倡议下,制定了罕见肺部疾病的实用治疗指南。这些指南由写作小组、评审小组和协调小组在OrphaLung网络以及不同执业模式的肺科医生、放射科医生、病理科医生、全科医生、护士长和患者协会的帮助下精心编写而成。该方法是根据法国官方卫生当局(HAS)“临床实践指南”总体框架中名为“良好临床实践”的规则制定的,同时考虑了使用李克特量表进行的在线投票结果。

结果

在对文献进行分析后,工作组制定、完善并验证了54条建议。这些建议涵盖了该疾病及其治疗的广泛方面:流行病学、诊断方式、胸部CT的质量标准及解读、肺活检的指征及方式、病因检查、家族性疾病的处理(包括基因检测的指征及方式)、对可能的功能损害和预后的评估、抗纤维化治疗的指征及使用、肺移植、症状管理、合并症和并发症、慢性呼吸衰竭的治疗、纤维化急性加重的诊断和管理。

结论

这些循证指南旨在指导特发性肺纤维化临床实践中的诊断和管理。

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