标准·方案·指南
ENGLISH ABSTRACT
儿童社区获得性肺炎管理指南(2024修订)
中华医学会儿科学分会呼吸学组
中华儿科杂志编辑委员会
中国医药教育协会儿科专业委员会
作者及单位信息
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DOI: 10.3760/cma.j.cn112140-20240728-00523
Guidelines for the management of community-acquired pneumonia in children (2024 revision)
The Subspecialty Group of Respiratory, the Society of Pediatrics, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
China Medicine Education Association Committee on Pediatrics
Lu Quan
Shen Kunling
Authors Info & Affiliations
The Subspecialty Group of Respiratory, the Society of Pediatrics, Chinese Medical Association
the Editorial Board, Chinese Journal of Pediatrics
China Medicine Education Association Committee on Pediatrics
Lu Quan
Department of Respiratory Medicine, Shanghai Children′s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
Shen Kunling
Department of Respiratory, Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China
·
DOI: 10.3760/cma.j.cn112140-20240728-00523
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摘要

2013年我国制订的“儿童社区获得性肺炎管理指南(2013修订)”为临床医生规范诊断及治疗儿童社区获得性肺炎提供了很大帮助。随着医学发展,社区获得性肺炎的诊断、治疗及预防等也发生了变化,由中华医学会儿科学分会呼吸学组、中华儿科杂志编辑委员会和中国医药教育协会儿科专业委员会共同发起“儿童社区获得性肺炎管理指南(2024修订)”,对2013年指南进行更新,以提高儿科医生对社区获得性肺炎的诊疗水平,落实有效防治措施。

引用本文

中华医学会儿科学分会呼吸学组,中华儿科杂志编辑委员会,中国医药教育协会儿科专业委员会. 儿童社区获得性肺炎管理指南(2024修订)[J]. 中华儿科杂志,2024,62(10):920-930.

DOI:10.3760/cma.j.cn112140-20240728-00523

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更正

本文中第925页表7儿童肺炎病情严重度评估:肺浸润范围:轻症“≤1/3单肺叶”改为“≤1/3单侧肺”,重症“多肺叶或单肺叶≥2/3受累”改为“双侧肺多叶或≥2/3单侧肺”。更正的同时表示歉意!

社区获得性肺炎(简称肺炎)是指原本健康的儿童在医院外获得的感染性肺炎,包括感染了具有明确潜伏期的病原体而在入院后潜伏期内发病的肺炎,是儿童期常见的感染性疾病 1 , 2。2013年我国制订的“儿童社区获得性肺炎管理指南(2013修订)” 3 , 4,被广泛应用于临床,但随着医学发展,儿童肺炎病原谱、病原学检测技术、病原细菌的耐药等均有所变化。因此,为进一步规范诊治,由中华医学会儿科学分会呼吸学组、中华儿科杂志编辑委员会和中国医药教育协会儿科专业委员会共同发起“儿童社区获得性肺炎管理指南(2024修订)”(简称本指南),对2013年指南进行修订;由首都医科大学附属北京儿童医院临床流行病学与循证医学中心提供技术支持与方法学指导。本指南工作组成员由多学科专家组成,主要包括临床医师、放射科医师、药师和方法学专家等10个工作小组撰写。通过会议讨论确定指南的整体框架和主要更新内容,由方法学专家对所有编写专家进行文献检索和证据等级评价的规范化培训。主要检索PubMed、Embase、中国知网等数据库,相关临床证据检索截止日期为2024年6月。证据等级参考慢性阻塞性肺疾病全球倡议指南使用的证据质量分级( 表15。初稿完成后,执笔人负责汇总并修改,再通过工作会议讨论修订,并由外部同行专家进行评审,根据其反馈意见进行完善形成终稿,获全体专家同意。本指南历时2年,在国际实践指南注册与透明化平台注册号为(PREPARE-2022CN682)。指南的目标人群为29日龄至18岁的肺炎患儿,适用各级医疗机构参与儿童肺炎诊断和治疗的相关工作人员。在本指南发布后5年左右依据国际指南更新流程更新。
证据质量等级 证据来源 描述
高(A) 多项RCT 证据来源于多项设计良好,且采用终点指标的RCT,多项RCT没有任何严重局限性,且针对拟推荐人群能提供一致的研究结果
大量的,没有明显局限性或偏倚的高质量研究 两项及以上样本量足够大的临床试验提供的高质量证据,或一项没有任何偏倚,样本量足够大的高质量RCT研究
中(B) 有多项具有严重局限性的RCT 证据来源于患者样本量有限的RCT,RCT的亚组分析或事后分析,或基于RCT的Meta分析
有限的证据 几乎没有RCT或有一些存在明显的重大缺陷的RCT,如方法学错误、样本量小、持续时间短、研究人群与拟推荐目标人群不一致,或不同研究的结果间存在不一致
低(C) 非随机试验或观察性研究 证据来源于未设立对照或非实施随机化的临床试验或观察性研究
极低(D) 专家小组共识 专家一致认为有价值,但阐述这一问题的临床研究文献并不充分;基于临床经验或知识达成的小组共识,但这些共识缺乏满足上述标准的证据
证据等级的分级标准

注:RCT随机对照试验

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备注信息
A
陆权,上海交通大学医学院附属儿童医院呼吸科,上海 200062,Email: mocdef.aabnis.pivhs-nauqul
B
申昆玲,首都医科大学附属北京儿童医院呼吸科,北京 100045,Email: mocdef.3ab617171nehsgnilnuk
C
中华医学会儿科学分会呼吸学组, 中华儿科杂志编辑委员会, 中国医药教育协会儿科专业委员会. 儿童社区获得性肺炎管理指南(2024修订)[J]. 中华儿科杂志, 2024, 62(10): 920-930. DOI: 10.3760/cma.j.cn112140-20240728-00523.
D
所有作者声明无利益冲突
E
中国医学科学院临床与转化医学研究专项 (2023-I2M-C&T-A-015)
北京市卫生健康委员会高层次公共卫生技术人才建设项目 (学科带头人-01-23)
北京市研究型病房建设示范单位项目 (BCRW202101)
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