呼吸道疾病的评定与处理指导

WorldOrganizationofFamilyDoctors(Wonca)Forum,Beijing,2006WilliamK.Dolen,MDMedicalCollegeofGeorgia,AugustaGuidelinesforEvaluationandManagementofRespiratoryDiseases呼吸道疾病的评定和处理指南GARD全球防慢性呼吸疾病联盟

Workingtowardsthecommongoaloffightingchronicrespiratorydiseases针对向慢性呼吸病斗争的一般目标的工作Identifyingproblems确认问题Promotingsolutions推动解决Coordinatingactivities协调活动Sharingexpertise;encouragingandfacilitatinginformationexchange参与的专家；鼓励支持信息交流Sharedexpertise技术共享Throughouttheworld,physiciangroupshavedeveloped“guidelines”forthediagnosisandmanagementofrespiratorydisease全世界的医生组织都制订了呼吸病诊断治疗指南Theseguidelinesaremostlyevidence-based这些指南大多为循证性MostareavailablefromtheWorld-WideWeb大多数可从全世界范围的网络上找到Advantagesofguidelines指南的优点Disadvantagesofguidelines

指南的不足Sinceguidelinesareconsensusrecommendations,theyarenotappropriateforallpatients

指南为共性的推荐内容，不一定适用于所有患者Guidelinesarenotasubstituteforclinicalthinking指南不能代替临床思维Guidelinesmustberegularlyupdatedtoremainuseful;physiciansmustbekeptawareofupdates医生应意识到指南必须经常性修改，保持先进与实用Guidelinesdifferfromcountrytocountry,reflectingdifferentpracticestyles

不同国家有适合本国服务方式的指南Examples–1

例-1GlobalInitiativeforAsthma(GINA)

哮喘全球行动GlobalInitiativeforchronicObstructiveLungDisease(GOLD)

慢阻肺全球行动AllergicRhinitisanditsImpactonAsthma(ARIA)

过敏性鼻炎及其对哮喘的威胁Examples–2

例-2InternationalPrimaryCareAirwaysGroup(IPAG)primarycareworkbook国际呼吸道疾病基层医疗(IPAG)-基层医疗业务手册AvailablefromWONCA可从WONCA得到帮助Addressesdiagnosisandmanagementofrhinitis,asthma,COPD

提出鼻炎、哮喘、慢阻肺的诊断处理BasedonGINA,GOLD,ARIAguidelines

以GINA,GOLD,ARIA指南为基础Symptom-based,easytouse症状为基础,便于使用

Examples–3

例-3InternationalPrimaryCareRespiratoryGroup(IPCRG)Guidelines国际呼吸道疾病基层医疗组织(IPCRG)指南EntireissueofPrimaryCareRespiratoryJournal2006;15(1):1-74呼吸道疾病基层医疗的整体研究杂志2006;15(1):1-74Detailed,extensive细节与延伸Examples–4例-4NationalHeart,Lung,andBloodInstitute(NHLBI)GuidelinesfortheDiagnosisandManagementofAsthma

国立心肺血液研究所的哮喘诊治指南UsedinUSA在美国的应用Updateexpectedinlate2006今年下半年可望更新JointTaskforceonPracticeParameters