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美国胃肠病学会临床指南:成人克罗恩病的管理

ACG Clinical Guideline: Management of Crohn's Disease in Adults.

作者信息

Lichtenstein Gary R, Loftus Edward V, Afzali Anita, Long Millie D, Barnes Edward L, Isaacs Kim L, Ha Christina Y

机构信息

Division of Gastroenterology, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Am J Gastroenterol. 2025 Jun 3;120(6):1225-1264. doi: 10.14309/ajg.0000000000003465.

Abstract

Crohn's disease (CD) is an idiopathic inflammatory disorder of unknown etiology with genetic, immunologic, and environmental influences. The incidence of CD has steadily increased over the past several decades. The diagnosis and treatment of patients with CD has evolved since the last practice guideline was published. These guidelines represent the official practice recommendations of the American College of Gastroenterology and were developed under the auspices of the Practice Parameters Committee for the management of adult patients with CD. These guidelines are established for clinical practice with the intent of suggesting preferable approaches to medical problems as established by interpretation and collation of scientifically valid research, derived from extensive review of published literature. When exercising clinical judgment, health care providers should incorporate this guideline along with patient's needs, desires, and their values to care for patients fully and appropriately with CD. Shared decision-making with the patient is advocated. This guideline is intended to be flexible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care that are inflexible and rarely violated. To evaluate the level of evidence and strength of recommendations, we used the Grading of Recommendations Assessment, Development, and Evaluation system. The Committee reviews guidelines in depth, with participation from experienced clinicians and others in related fields. The final recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientific developments later.

摘要

克罗恩病(CD)是一种病因不明的特发性炎症性疾病,受遗传、免疫和环境因素影响。在过去几十年中,CD的发病率稳步上升。自上次发布实践指南以来,CD患者的诊断和治疗方法已经有所发展。这些指南代表了美国胃肠病学会的官方实践建议,由成人CD管理实践参数委员会主持制定。这些指南是为临床实践而制定的,旨在通过对已发表文献的广泛回顾,对科学有效的研究进行解读和整理,从而提出处理医学问题的优选方法。在行使临床判断力时,医疗保健提供者应将本指南与患者的需求、愿望及其价值观相结合,以全面、适当地照顾CD患者。提倡与患者共同决策。本指南旨在具有灵活性,不一定表明唯一可接受的方法,应与那些不灵活且很少被违反的护理标准区分开来。为了评估证据水平和推荐强度,我们使用了推荐分级评估、制定和评价系统。委员会在经验丰富的临床医生和相关领域的其他人员参与下,对指南进行了深入审查。最终建议基于文件编制时可用的数据,随后可能会随着相关科学进展进行更新。

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