《2009AASLD成人肝硬化腹水诊治指南更新》内容预览

This guideline has been approved by the AASLD and represents the position of the Association. These recom-mendations provide a data-supported approach. They are based on the following:
(1) formal review and analysis of the recently-published world literature on the topic (Medline search);
(2) American College of Physicians Manual for Assessing Health Practices and Designing Practice Guidelines;
(3) guideline policies, including the AASLD Policy on the Development and Use of Practice Guidelines and the American Gastroenterological Associ-ation Policy Statement on Guidelines; 
(4) the au-thor’s decades of experience caring for patients with cirrhosis and ascites.
Intended for use by physicians, these recommenda-tions suggest preferred approaches to the diagnostic, ther-apeutic, and preventive aspects of care. They are intended to be flexible, in contrast to standards of care, which are inflexible policies to be followed in every case. Specific recommendations are based on relevant published infor- mation. To more fully characterize the quality of evidence supporting recommendations, the Practice Guidelines Committee of the AASLD requires a Class (reflecting benefit versus risk) and Level (assessing strength or cer- tainty) of Evidence to be assigned and reported with each recommendation (Table 1, adapted from the American College of Cardiology and the American Heart Associa-tion Practice Guidelines).
These guidelines were developed for the care of adult patients with clinically detectable ascites. Although the general approach may be applicable to children, the pedi-atric database is much smaller and there may be unantic-ipated differences between adults and children. Patients with ascites detected only by imaging modalities but not yet clinically evident are excluded because of the lack of published information regarding the natural history of this entity

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