这是第一个专注于急性下消化道出血(LGIB)的英国国家指南,并已由英国胃肠病学会(BSG)的临床服务和标准委员会委托。指南开发小组由BSG内窥镜委员会的代表组成,大不列颠和爱尔兰结肠病学协会,英国介入放射学学会,皇家放射学院,NHS血液和移植以及患者代表。对文献进行了系统的搜索,并根据GRADE(建议评估的分级,开发和评估)方法。这些指南的重点是成人急性LGIB的诊断和治疗。包括诊断和治疗出血的风险评估和干预方法(结肠镜检查,计算机断层扫描,肠系膜血管造影,内镜治疗,栓塞和手术)。建议包括在接受抗凝剂(包括直接口服抗凝剂)或抗血小板药物时发展为LGIB的患者的管理。还讨论了输血的适当使用,包括血红蛋白触发器和目标。
This is the first UK national
guideline to concentrate on acute lower gastrointestinal bleeding (LGIB) and has been commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). The
Guidelines Development Group consisted of representatives from the BSG Endoscopy Committee, the Association of Coloproctology of Great Britain and Ireland, the British Society of Interventional Radiology, the Royal College of Radiologists, NHS Blood and Transplant and a patient representative. A systematic search of the literature was undertaken and the quality of evidence and grading of recommendations appraised according to the GRADE(Grading of Recommendations Assessment, Development and Evaluation) methodology. These
guidelines focus on the diagnosis and management of acute LGIB in adults, including methods of risk assessment and interventions to diagnose and treat bleeding (colonoscopy, computed tomography, mesenteric angiography, endoscopic therapy, embolisation and surgery). Recommendations are included on the management of patients who develop LGIB while receiving anticoagulants (including direct oral anticoagulants) or antiplatelet drugs. The appropriate use of blood transfusion is also discussed, including haemoglobin triggers and targets.