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Efficacy,durability,and safety of intravitreal faricimab up to every 16 weeks for neovascular age-related macular degeneration(TENAYA and LUCERNE):two randomised,double-masked,phase 3,non-inferiority trials

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四川生理科学杂志 2021年第11期43卷 1991-1991页

作者： Jeffrey S Heier Ophthalmic Consultants of Boston Boston MA USA Sierra Eye Associates Reno NV USA The University of Nevada Reno School of Medicine Reno NV USA Clinica de Ojos Garza Viejo San Pedro Garza Garcia Nuevo Leon Mexico Genentech South San Francisco CA USA Roche Products (ireland) Dublin Ireland Vitreoretinal Consultants of New York Great Neck NY USA Clinica Baviera Ramon y Cajal University Hospital Madrid Spain Department of Ophthalmology and GRADE Reading Center University of Bonn Bonn Germany Roche Products Welwyn Garden City UK Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong Special Administrative Region China Mid Atlantic Retina Wills Eye Hospital Thomas Jefferson University Philadelphia PA USA Hoffmann-La Roche Mississauga ON Canada Fondazione iRCCS Cà Granda Ospedale Maggiore policlinico Milan Italy Department of Clinical Sciences and Community Health University of Milan Milan Italy Singapore National Eye Centre Duke-NUS Medical School National University of Singapore Singapore

Background:Faricimab is a bispecific antibody that acts through dual inhibition of both angiopoietin-2 and vascular endothelial growth factor *** report primary results of two phase 3 trials evaluating intravitreal fa... 详细信息

关键词： degeneration macular durability

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糖尿病患者的手指结石:Huntley丘疹

世界核心医学期刊文摘（皮肤病学分册） 2006年第1期2卷 5-5页

作者： Guarneri C Guarneri F Borgia F Vaccaro M 焦婷 institute of Dermatology Policlinico Universitario Via Consolare Valeria Gazzi 98125 Messina Italy.Dr

A 60-year-old obese man was referred to our department from the internal medicine unit. He had a 20-year history of poorly controlled diabetes (no other cases in the family), and was admitted to hospital because of respiratory and consequent heart failure. Skin examination showed diffuse xerosis and a rough, sandpaper-like appearance of the skin of the finger, of approximately 15 years’duration, consisting of multiple, minute, hyperkeratotic papules grouped in a miniature “cobblestone”pattern on the dorsum of the distal phalanges (Fig. 1), more dense over the knuckles and the interphalangeal joints. No pruritus was present. He was a pensioner, who had been physically inactive for months previously, and this condition had occurred progressively in the absence of any known trauma. N o other cutaneous manifestations were evident. Histologic examination was perfor med using hematoxylin and eosin staining of a biopsy specimen taken from the lef t second finger; it displayed a hyperorthokeratotic epidermis with enlarged derm al papillae, thickened and vertically oriented collagen bundles, few elastic fib ers, and a mild perivascular inflammatory infiltrate.

关键词： Huntley 真皮乳头背侧心脏衰竭过度角化角化过度左手食指指间关节炎性浸润活检标本

动脉瘤性蛛网膜下腔出血患者的重症监护处理：神经危重症监护学会多学科共识会议的推荐意见

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国际脑血管病杂志 2013年第5期21卷 324-347页

作者： Michael N. Diringer Thomas P. Bleck J. Claude Hemphill David Menon Lori Shutter Paul Vespa Nicolas Bruder E. Sander Connolly Jr Giuseppe Citerio Daryl Gress Daniel Hanggi Brian L. Hoh Giuseppe Lanzino Peter Le Roux Alejandro Rabinstein, Erich Schmut zhard Nino Stocchetti Jose i. Suarez Miriam Tresgiari Ming-Yuan Tseng Mervyn D. i. Vergouwen Stefan Wolf Gregory Zip fel 田飞(译) 宿英英(译) From the Neurology/Neurosurgery intensive Care Unit Washingion University St. Louis MO USA Rush Medical College Chicago IL USA University of California at San Francisco San Francisco CA USA University of Cambridge Cambridge UK University of Cincinnati Cincinnati OH USA University of California at Los Angeles LOs Angeles CA USA Universit6 de la M.diterranae Marsedle France Columbia University New York NY USA San Gerardo hospital Monza Italy University of Virginia Charlottesville VA USA Heinrich-Heine University Dttsseldorf Germany University of Florida Gainesville FL USA Mayo Clinic Rochester MN USA University of Pennsylvania Philadelphia PA USA University hospital innsbruck lnnsbruck Austria Fondazione iRCCS Ch Granda- Ospedale policlinico Milan University Milan Italy University of Washington St. Louis MO USA Baylor College of Medicine Houston TX USA Nottingham University hospitals Nottingham UK University of Utrecht Utrecht The Netherlands Freie Universitit Berlin Berlin Germany Washington University St. Louis MO USA 首都医科大学宣武医院神经内科北京100053

蛛网膜下腔出血（subarachnoidhemorrhage，SAH）是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏，使得治疗方法... 详细信息

蛛网膜下腔出血（subarachnoidhemorrhage，SAH）是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏，使得治疗方法各异，可供选择的指导意见不多。现有的指南主要强调危险因素、预防、自然史以及再出血的预防，很少涉及SAH患者的重症监护问题。美国神经危重症监护学会组织了一次国际性多学科共识会议来探讨SAH的重症监护处理。根据发表的文章和研究领域，此次会议召集了来自欧洲和北美地区的神经重症监护科、神经外科、神经内科、介入神经放射科和神经麻醉科方面的专家。根据临床经验和制定实践指南方面的经验，选择4名经验丰富的神经重症监护专家组成评判委员会。应用推荐分级的评估、制定与评价（GradesofRecommendationsAssessment，DevelopmentandEvaluation，GRADE）系统进行文献回顾，结合参会者的经验、评判委员会的审评以及文献讨论产生推荐意见。应用GRADE系统制定推荐意见，其制定原则不仅强调研究资料的质量，而且还重视利弊权衡与实践转化。对SAH患者日常处理过程中面临的所有问题均提供指导和推荐意见，即使缺乏高质量的证据。

关键词：蛛网膜下腔出血重症监护动脉瘤血管痉挛抗惊厥药低钠血症血管内发热

急性A型主动脉夹层的早期和晚期预后:487例连续病例危险因素的分析

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世界核心医学期刊文摘（心脏病学分册） 2005年第8期1卷 45-45页

作者： Chiappini B. Schepens M. Tan E. 任付先 Department of Cardiovascular Surgery Policlinico S.Orsola- Malpighi via Massarenti 9 40138 Bologno Italy

Aims: The purpose of this retrospective study was to assess the risk factors for the early and late outcome of the surgical treatment of acute typeA aortic dissection, in terms of mortality and morbidity. Methods and results: From 1976 to 2003, 487 patients with acute type A aortic dissection treated surgically were enrolled. Twenty- five pre- operative and intra- operative variables were analysed to identify conditions influencing early and late morbidity and early mortality. The in- hospital mortality rate including operative death was 22% (107 patients). Multivariable analysis indicated that pre- existing cardiac disease(RR=3.7, 95% Ci=1.8- 7.4) and cardiopulmonary resuscitation(RR=6.8, 95% Ci=2.3- 20.2) were independent predictors of in- hospital death. The causes of in- hospital mortality were low cardiac output in 32 patients(6.6% ), major brain damage in 24 patients(5.9% ), haemorrhage in 11 patients(2.2% ), sepsis in nine patients(1.8% ), visceral ischaemia in eight patients(1.6% ), multiple organ failure in seven patients(1.4% ), rupture of the thoracic aorta in six patients(1.2% ), respiratory failure in six patients(1.2% ), and four intra- operative deaths. The follow- up was 100% complete. The actuarial survival was 94.9± 1.2% and 88.1± 2.6% , at 5 and 10 years, respectively. Conclusions: Patients pre- operative co- morbidities and dissection- related complications significantly affect early and late survival and morbidity after surgical treatment of acute type A aortic dissection.

关键词：主动脉夹层心肺复苏脓毒症早期死亡率心输出量呼吸衰竭胸主动脉多器官衰竭多因素分析

AME证据系列001--转化医学协会:脓毒症诊断和早期识别的临床实践指南

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临床与病理杂志 2016年第10期36卷 1467-1476页

作者： Zhongheng Zhang Nathan J.Smischney Haibo Zhang Sven Van Poucke Panagiotis Tsirigotis Jordi Rello Patrick M.Honore Win Sen Kuan Juliet June Ray Jiancang Zhou You Shang Yuetian Yu Christian Jung Chiara Robba Fabio Silvio Taccone Pietro Caironi David Grimaldi Stefan Hofer George Dimopoulos Marc Leone Sang-Bum Hong Mabrouk Bahloul Laurent Argaud Won Young Kim Herbert D.Spapen Jose Rodolfo Rocco 张建成(译) 尚游(译) 钟鸣(校) Department of Emergency Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Jinhua Hospital of Zhejiang UniversityJinhua Zhejiang 321000 Department of Anesthesiology Mayo ClinicRochesterMNUSA Keenan Research Center for Biomedical Science of St.Michael's hospital Departments of Anesthesia and PhysiologyInterdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoONCanada Departments of Anesthesiology Critical CareEmergency Medicine and Pain TherapyZiekenhuis Oost-Limburgy GenkBelgium 2nd Department of internal Medicine Attikcon University HospitalMedical SchoolNational and Kapodistrian University of AthensAthensGreece CiBERES Vall d'Hebron Institut of ResearchUniversitat Autonoma de BarcelonaSpain Universitair Ziekenhuis Brussely Vrije Universiteit Brussel Brussels BrusselsBelgium Emergency Medicine Department National University HospitalNational University Health SystemSingapore and the Department of SurgeryYong Loo Lin School of MedicineNational University of SingaporeSingapore DeWitt Daughtry Family Department of Surgery Jackson Memorial HospitalUniversity of Miami Leonard M.Miller School of MedicineMiamiFLUSA Department of Critical Care Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016 Department of Critical Care Medicine Union HospitalTongji Medical CollegueHuazhong University of Science and TechnologyWuhan 430022 Department of Critical Care Medicine Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200001 University hospital Dusseldorf Heinrich-Heine-University DusseldorfMedical FacultyDivision of CardiologyPulmonology and Vascular MedicineDusseldorfGermany Neurosciences Critical Care Unit Addenbrooke's HospitalCambridgeUK Department of intensive Care Hopital ErasmeUniversite Libre de Bruxelles(ULB)BrusselsBelgium Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti Fondazione IRCCS Ca'Granda-Ospedale

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊... 详细信息

脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。

关键词：脓毒症早期识别诊断

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欧洲卒中组织脑静脉血栓形成诊断和治疗指南

国际脑血管病杂志 2017年第11期25卷 961-971页

作者： J. M. Ferro M.-G. Bousser P. Canhao J. M. Coutinho i. Crassard F. Dentali M. di Minno A. Maino i. Martinelli F. Masuhr D. Aguiar de Sousa J. Stam 黄菲虹许岩朱武生 From the Department of Neurosciences Servico de Neurologia Hospital de Santa Maria Lisboa Universidade de Lisboa Lisboa Portugal Service de Neurologie H^opital Lariboisi_ere Paris France Department of Neurology Academic Medical Center Amsterdam The Netherlands Department of Clinical Medicine Insubria University Varese Department of Clinical Medicine and Surgery Regional Reference Centrefor Coagulation Disorders 'Federico II' University Naples Unit of Cell and Molecular Biology in Cardiovascular Diseases Centro Cardiologico Monzino IRCCS Milan A. Bianchi Bonomi Hemophilia and Thrombosis Centre Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico Milan Italy Department of Neurology BundeswehrkrankenhausBerlin Germany 南京大学医学院附属金陵医院(南京军区南京总医院)神经内科 210002

背景和目的目前的脑静脉血栓形成（cerebral venous thrombosis, CVT）诊断和治疗指南是欧洲神经病学学会联盟在2010年发布的，本文旨在通过更为通俗易懂和循证的方法对先前的指南进行更新。方法我们遵循推荐意见分级评估、制定和评价（... 详细信息

背景和目的目前的脑静脉血栓形成（cerebral venous thrombosis, CVT）诊断和治疗指南是欧洲神经病学学会联盟在2010年发布的，本文旨在通过更为通俗易懂和循证的方法对先前的指南进行更新。方法我们遵循推荐意见分级评估、制定和评价（Grading of Recommendations, Assessment, Development and Evaluation, GRADE）系统，提出相关诊断和治疗问题、进行系统评价并根据现有的科学证据质量制定推荐意见。结果我们建议通过磁共振血管造影或CT血管造影对CVT进行确诊，但不建议对CVT患者常规进行血栓形成倾向或癌症筛查。我们推荐对急性CVT进行胃肠外抗凝治疗，并进行减压手术以避免因脑疝而引起死亡。我们建议在急性期优先选用低分子肝素而非直接口服抗凝药。我们不建议使用类固醇和乙酰唑胺来降低死亡或生活依赖风险。我们建议对早期有癫痫发作以及幕上病变的患者应用抗癫痫药来预防进一步的早期癫痫发作。关于急性期后抗凝治疗的疗程、溶栓和（或）机械血栓切除术、治疗性腰椎穿刺以及利用抗癫痫药预防远期癫痫发作，我们无法提出推荐意见。我们建议既往有CVT史的女性应避免使用含有雌激素的避孕药。患CVT之后妊娠是安全的，但建议应在整个妊娠期和产褥期考虑预防性使用低分子肝素。结论需要多中心观察性和实验性研究来提高支持CVT诊断和治疗推荐意见的证据水平。

关键词：乙酰唑胺血管造影抗凝抗癫痫药癌症筛查脑静脉血栓形成避孕 D-二聚体减压手术硬膜窦血栓形成推荐意见分级评估制定和评价偏侧颅骨切除术肝素腰椎穿刺妊娠血栓形成倾向筛查产褥期分流术类固醇血栓切除术溶栓静脉造影

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国际妇产科超声学会早孕期胎儿超声指南

妇产与遗传(电子版) 2014年第3期4卷 54-64页

作者： L.J.Salomon Z.Alfirevic C.M.Bilardo G.E.Chalouhi T.Ghi K.O.Kagan T.K.Lau A.T.Papageorghiou N.J.Raine-Fenning J.Stirnemann S.Suresh A.Taborl i.E.Timor-Tritsch A.Toi G.Yeo 杨芳梁国贤 Department of Obstetrics and Fetal Medicine and SFAPE(Societe Francaise d' Ameliorationdes Pratiques Echographique) Paris Descartes UniversityAssistance Publique-Hopitaux de ParisHopital Necker Enfants Department for Women' s and Children's Health University of Liverpool Fetal Medicine Unit Department of Obstetrics and GynaecologyUniversity Medical Centre Groningen Department of Obstetrics and Gynaecology Policlinico S.Orsola-MalpighiUniversity of Bologna Department of Obstetrics and Gynecology University of Tuebingen Fetal Medicine Centre Paramount ClinicCentral 7. Fetal Medicine UnitSt George' sUniversity of London 8. Division of Obstetrics & GynaecologySchool of Clinical SciencesUniversity of Nottingham 9. Obstetrics and Fetal MedicineGHU Necker-Enfants MaladesUniversity Paris Descartes 10. Mediscan Systems&Fetal Care Research Foundation 11. Fetal Medicine UnitDepartment of ObstetricsRigshospitaletCopenhagen University Hospital 12. Department of Obstetrics and GynecologyNew York University School of Medicine 13. Medical Imaging andObstetrics and GynaecologyMount Sinai HospitalUniversity of Toronto 14. Department of Maternal Fetal MedicineObstetric Ultrasound and Prenatal Diagnostic UnitKK Women' s and Children's Hospital 15. 南方医科大学南方医院妇产科产前诊断中心 16. 香港伊丽莎伯医院妇产科

一、临床标准委员会国际妇产科超声学会(iSUOG)是以推进安全的临床实践、提供高质量的医学教学、推动与妇女健康相关的影像学诊断研究为宗旨的科学组织。iSUOG临床标准委员会(CSC)的工作范畴包括制订实践指南、发布共识声明,为医疗工作... 详细信息

一、临床标准委员会国际妇产科超声学会(iSUOG)是以推进安全的临床实践、提供高质量的医学教学、推动与妇女健康相关的影像学诊断研究为宗旨的科学组织。iSUOG临床标准委员会(CSC)的工作范畴包括制订实践指南、发布共识声明,为医疗工作者提供基于业内共识的影像学诊断方法。这些指南和共识是iSUOG在其发表时确认的最优方案。虽然iSUOG会尽力确保发布内容的准确性,但学会及其雇员或会员均不会为CSC所发表的不准确或具误导性的资料、意见或陈述所造成的后果承担任何责任。iSUOG、CSC所发表的

关键词：早孕期超声检查胎儿超声头臀长双顶径妇产科

免疫疗法联合立体定向放疗治疗非小细胞肺癌脑转移:一项AiRO多中心回顾性研究

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中国肺癌杂志 2022年第4期25卷 I0007-I0022页

作者： Silvia SCOCCiANTi Emanuela OLMETTO Valentina PiNZi Mattia Falchetto OSTi Rossella Di FRANCO Saverio CAiNi Paola ANSELMO Paolo MATTEUCCi Davide FRANCESCHiNi Cristina MANTOVANi Giancarlo BELTRAMO Francesco PASQUALETTi Alessio BRUNi Paolo TiNi Emilia GiUDiCE Patrizia CiAMMELLA Anna MERLOTTi Sara PEDRETTi Marianna TRiGNANi Marco KRENGLi NiccolòGiAJ-LEVRA isacco DESiDERi Guido PECCHiOLi Paolo MUTO Ernesto MARANZANO Laura FARiSELLi Pierina NAVARRiA umberto RiCARDi Vieri SCOTTi Lorenzo LiVi 王绿化(翻译/校对) Radiation Oncology Unit Ospedale Santa Maria AnnunziataDepartment of OncologyBagno a RipoliFlorenceItaly Radiation Oncology Unit Azienda Ospedaliero Universitaria CareggiDepartment of Experimental and Clinical Biomedical Sciences"Mario Serio"FlorenceItaly U.O Radioterapia Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of NeurosurgeryMilanItaly U.O.C Radioterapia A.O.U Sant'Andrea Facolta Medicina e Psicologia Universita SapienzaDepartment of MedicineSurgery and Translational MedicineRomeItaly istituto Nazionale Tumori iRCCS Fondazione G.PascaleDepartment of RadiotherapyNaplesItaly institute for Cancer Research Prevention and Clinical Network(ISPRO)Cancer Risk Factors and Life-Style Epidemiology UnitFlorenceItaly Radiotherapy Oncology Center S.Maria HospitalDepartment of OncologyTerniItaly Humanitas Research hospital Radiotherapy and Radiosurgery DepartmentRozzanoItaly Radiotherapy Unit Department of OncologyTurinItaly Cyberknife Centro Diagnostico italiano Department of RadiologyMilanItaly Radiation Oncology Azienda Ospedaliero Universitaria PisanaDepartment of Translational MedicinePisaItaly Radiotherapy Unit University Hospital of ModenaDepartment of Oncology and HematologyModenaItaly Radiotherapy Unit University of SienaDepartment of Radiotherapy and OncologySienaItaly UOC di Radioterapia Policlinico Universitario Tor VergataDepartment of Onco-HaematologyRomeItaly Radioterapia Oncologica"G.Prodi "AO-IRCCS Arcispedale S.Maria NuovaDepartment of Oncology and Advanced TechnologyReggio EmiliaItaly Radiation Oncology A.S.O.S.Croce e Carle Department of Radiation OncologyCuneoItaly U.O.Radioterapia Oncologica Department of Radiation OncologyASST Spedali Civili di Brescia e Universita degli studi di BresciaBresciaItaly U.O.C.Radioterapia Oncologica Ospedale Clinicizzato SS Annunziata-Universita Chieti G.D'AnnunzioDepartment of Radiation OncologyChietiItaly Radiation Oncology University Hospital Maggiore della CaritdDepartment of Translational Medicine

背景与目的通过意大利放射治疗和临床肿瘤学学会(italian Association of Radiotherapy and Clinical Oncology, AiRO)的一项多中心回顾性研究,明确免疫疗法(immunotherapy, iT)和立体定向放疗(stereotactic radiotherapy,SRT)包括放射外科治疗(radiosurgery, RS)或大分割立体定向放疗(hypofractionated stereotactic radiotherapy, HFSRT)治疗非小细胞肺癌(non-small cell lung cancer, NSCLC)脑转移的疗效和毒性。方法对来自19个意大利中心接受SRT+iT的NSCLC伴脑转移患者进行分析,并与单独接受SRT的对照组患者进行比较。结果共纳入SRT+iT组100例和单独SRT组50例。接受SRT+iT的患者有更长的颅内局部无进展生存期(intracranial local progression-free survival, i LPFS)(经倾向性评分调整后,P=0.007)。在诊断为脑转移时接受iT合并有颅外进展的患者中(n=24),接受SRT后再进行iT与较好的总生存期(overall survival, OS)相关(P=0.037)。多因素分析显示组织学类型为非腺癌、卡氏体能状态(Karnofsky performance status,KPS)评分=70分以及接受HFSRT与显著减少的生存期相关(P值分别为0.019、0.017和0.007)。与SRT和iT治疗间隔>7天(n=10)相比,治疗间隔≤7天(n=90)与更长的OS相关(经倾向性评分调整后,P=0.008)。联合治疗耐受性良好。在放射性坏死方面,接受SRT+iT的患者与单独SRT的患者无显著差异。SRT和iT的治疗间隔对毒性发生率无影响。结论 SRT+iT是一种安全的联合治疗方法,与单独SRT相比,具有更长的i LPFS。

关键词：立体定向放疗回顾性研究脑转移倾向性评分临床肿瘤学免疫疗法放射治疗

神经重症监护患者的液体治疗:ESiCM专家共识及临床实践推荐

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国际脑血管病杂志 2019年第2期27卷 84-97页

作者： Mauro Oddo Daniele Poole Raimund Helbok Geert Meyfroidt Nino Stocchetti Pierre Bouzat Maurizio Cecconi Thomas Geeraerts ignacio-Martin Loeches Herve Quintard Fabio Silvio Taccone Romergryko G. Geocadin Claude Hemphill Carole ichai David Menon Jean-Francois Payen Anders Perner Martin Smith Jose Suarez Walter Videtta Elisa R. Zanier Giuseppe Citerio 何毅华(译) 常远(译) 王晓蔷(译) 潘速跃(译) Department of Medic al-Surgical intensive Care Medicine Faculty of Biology and Medicine Centre Hospitalier Universitaire VauDOIs (CHUV) Lhiversity of Lausanne Rue du Bugnon 46 B4 08.623 1011 Lausanne Switzerland Department of intensive Care Medicine St James's Lhiversity Hospital James's St Ushers P.O. Box 580 Dublin & Ireland Service de Reanimation Medic o-chirurgic ale Hopital Pasteur 2 UniversiteCote d'Azur CHU de Nice 06000 Nice France Unite CNRS 7275 Sophia-Antipolis France Department of intensive Care Erasme Hospital University Libre de Bruxelles Brussels Belgium Neurosciences Critical Care Departments of Anesthesiology and Critical Care Medicine Neurology and Neurosurgery Johns Hopkins Lhiversity Baltimore MD USA Department of Neurology University of California San Francisco San Francisco CA LKA Service de Reanimation Polyvalente Hopital Pasteur 2 CHU de Nice 30 Voie Romaine CS 51069 06001 Nice Cedex 1 France Division of Anaesthesia University of Cambridge Addenbrooke's Ffospital Box 93 Hfills Road Cambridge Cambridgeshire CB2 2QQ UK Department of intensive Care 4131 Copenhagen University Hospital- Rigshospitalet Copenhagen Denmark Department of Neuroanesthesia and Neurocritic al Care The National Ffospital for Neurosurgery and Neurology Lhiversity College London Hospitals London UK Anesthesia and intensive Care Operative th it S. Martino Hospital Belluno Italy hospital Nacional Professor Alejandro Posadas Buenos Aires Argentina Department of Neurosciences IRCCS-Istituto di Ricerche Farmacotogiche Mario Negri Milan Italy School of Medicine and Surgery University of Milan-Bicocca Milan Italy Neurointensive Care San Gerardo Hospital ASST-Monza 20900 Monza Italy 南方医科大学南方医院神经内科广州510515 Neurological intensive Care Lhit Department of Neurology Medical University of Innsbruck Innsbruck Austria Department of intensive Care Medicine University Hospitals Leuven Louvain Belgium Neuroscience intensive Care Unit Department of Anesthesia and C

目的发布欧洲重症医学学会(European Society of intensive Care Medicine, ESiCM)关于神经重症监护患者液体治疗的专家共识和临床实践推荐意见。设计在2016年10月召开的ESiCM LiVE 2016会议上召集了一个由22名国际专家组成的共识委员会... 详细信息

目的发布欧洲重症医学学会(European Society of intensive Care Medicine, ESiCM)关于神经重症监护患者液体治疗的专家共识和临床实践推荐意见。设计在2016年10月召开的ESiCM LiVE 2016会议上召集了一个由22名国际专家组成的共识委员会,随后委员会成员通过电话会议和在线讨论制定本专家共识。方法回顾人群、干预、对比和结局(population, intervention,comparison, and outcomes, PiCO)问题,根据需要进行更新并得到证据概要。本共识关注3个主要议题:(1)神经重症监护患者的液体复苏和维持;(2)高渗液体在颅内压控制中的应用;(3)蛛网膜下腔出血后迟发性脑缺血的液体管理。经过广泛的文献检索,应用推荐分级的评估、制订与评价(Gradingof Recommendations Assessment, Development and Evaluation, GRADE)系统原则评估证据质量(从高到极低),制定治疗推荐(强或弱),并在适用时发布最佳实践声明。基于文献和专家意见提供的综合证据,应用改良德尔菲方法(使用序贯方法以避免偏倚和误解)产生最终共识声明。结果最终共识包含总共32条声明,其中13条为强推荐,17条为弱推荐,另外2条声明未提供推荐意见。结论我们发布了一份关于神经重症监护患者液体治疗的共识声明和临床实践推荐。

关键词：循证医学指南液体治疗创伤性脑损伤蛛网膜下腔出血脑出血卒中甘露醇高渗神经重症监护