血管外科学会(SVS),美国静脉论坛(AVF),美国静脉和淋巴学会(AVLS)最近发布了2022年静脉曲张临床实践指南的第一部分。建议基于对影响下肢静脉曲张患者管理的五个关键问题进行独立系统评价和荟萃分析后研究的最新科学证据,使用PICO(患者,干预措施,比较器,和结果)系统来回答关键问题。第一部分讨论了双工超声扫描(DUS)在评估静脉曲张和治疗浅层躯干反流中的作用。第二部分重点介绍支持预防和管理静脉曲张患者压迫的证据,用药物和营养补充剂治疗,关于静脉曲张支流的评估和治疗,浅静脉动脉瘤,以及静脉曲张并发症的处理及其治疗。所有准则都基于系统审查,根据证据水平和建议强度对他们进行分级,使用等级方法。所有未分级的共识声明都得到了广泛文献综述和专家一致同意的支持,多学科小组。未分级的良好做法声明是仅由间接证据支持的建议。主题,然而,通常没有争议,并得到大多数利益相关者的同意。实施备注包含支持实施具体建议的技术信息。这份全面的文件包括所有建议的清单(第一至第二部分),未分级的共识声明,实施说明,和最佳实践声明,以帮助从业人员适当的,下肢静脉曲张患者的最新管理。
The Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society recently published Part I of the 2022 clinical practice
guidelines on varicose veins. Recommendations were based on the latest scientific evidence researched following an independent systematic review and meta-analysis of five critical issues affecting the management of patients with lower extremity varicose veins, using the patients, interventions, comparators, and outcome system to answer critical questions. Part I discussed the role of duplex ultrasound scanning in the evaluation of varicose veins and treatment of superficial truncal reflux. Part II focuses on evidence supporting the prevention and management of varicose vein patients with
compression, on treatment with drugs and nutritional supplements, on evaluation and treatment of varicose tributaries, on superficial venous aneurysms, and on the management of complications of varicose veins and their treatment. All
guidelines were based on systematic reviews, and they were graded according to the level of evidence and the strength of recommendations, using the GRADE method. All ungraded
Consensus Statements were supported by an extensive literature review and the unanimous agreement of an expert, multidisciplinary panel. Ungraded Good Practice Statements are recommendations that are supported only by indirect evidence. The topic, however, is usually noncontroversial and agreed upon by most stakeholders. The Implementation Remarks contain technical information that supports the implementation of specific recommendations. This comprehensive document includes a list of all recommendations (Parts I-II), ungraded
consensus statements, implementation remarks, and best practice statements to aid practitioners with appropriate, up-to-date management of patients with lower extremity varicose veins.