摘要
目的系统综述现有循证医学证据,提出儿童血栓性疾病的药物防治建议;制订全面且实用的儿童血栓性疾病防治药学实践指南,提高儿童血栓防治的合理用药水平。方法采用世界卫生组织(WHO)指南制定手册进行指南研究设计;系统检索并广泛收集全国范围内存在的防治儿童血栓常见用药问题,采用德尔菲法调研专家并确定最终纳入的临床问题;再进行系统文献检索,对现有的原始研究、系统评价以及专业组织的指南或共识等进行综合评估,按照制定与评价系统(GRADE)方法进行质量评价,再次通过德尔菲法对推荐意见及证据级别达成共识,最终形成《儿童血栓性疾病防治药学实践指南》。结果指南在制订过程中共收集来自74位临床药学和临床医学的专家评估的29个临床问题,通过两轮调查问卷筛选出15个临床问题,并在2名方法学专家监督下制订了15项临床用药推荐意见。结论通过对临床实践的可行性和安全性进行全面评估,指南为儿科医务工作者提供了具体的抗栓用药建议,有助于提高儿童血栓的防治水平,促进更规范、更有效的医疗实践。
Objective In order to improve the rationalization of medication use for thrombosis prevention and treatment in children,the guideline aims to develop a comprehensive and practical guideline for pharmacy practice in the prevention and treatment of thromboembolic diseases in children.Through a systematic review of the available evidence-based medical evidence,specific recommendations for drug prevention and treatment are presented.Methods The World Health Organization(WHO)guideline development manual was used for the study design of the guideline.A systematic search and extensive collection of common medication problems for the prevention and treatment of thrombosis in children existed nationwide,and the Delphi method was used to research experts and determine the final clinical problems to be included.Then,a systematic literature search was conducted to comprehensively assess the existing original studies,systematic evaluations,and guidelines or consensus of professional organizations.Quality evaluation was conducted according to the grades of recommendations assessment,development and evaluation(GRADE)method,and consensus on the recommendations and level of evidence was reached again through the Delphi method,which ultimately led to the formation of the pharmacy practice guidelines for the prevention and treatment of thromboembolic diseases in children.Results A total of 29 clinical problems assessed by 74 experts in clinical pharmacy and clinical medicine were collected during the development of the guideline;15 clinical problems were screened through two rounds of questionnaires;and 15 clinical medication recommendations were developed under the supervision of two methodologists.Conclusion By comprehensively evaluating the feasibility and safety of clinical practice,the guideline will provide specific antithrombotic medication recommendations for pediatric healthcare professionals,which will help improve the prevention and treatment of thrombosis in children and promote more standardized and effective medical practice.
作者
四川省医学科学院·四川省人民医院
电子科技大学医学院
个体化药物治疗四川省重点实验室
中华医学会临床药学分会
中国心胸血管麻醉学会心血管药学分会
边原
Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital;School of Medicine,University of Electronic Science and Technology of China;Personalized Drug Therapy Key Laboratory of Sichuan Province;Clinical Pharmacy Branch,Chinese Medical Association;Cardiovascular Pharmacy Branch,Chinese Society of Cardiothoracic and Vascular Anesthesiology
出处
《医药导报》
CAS
北大核心
2024年第7期1017-1038,共22页
Herald of Medicine
基金
国家重点研发计划(2020YFC2005506)
四川省科技厅自然科学基金(2022NSFSC0818)
四川省药品监督管理局科技计划项目(2024012)
个体化药物治疗四川省重点实验室开放课题(2021ZD01)。
关键词
儿童血栓
合理用药
血栓防治
药学实践指南
Thrombosis in children
Rational medication use
Thrombosis prevention and treatment
Pharmacy practice guideline
