中华眼底病杂志

中华眼底病杂志

中国老年性黄斑变性临床诊断治疗路径

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目的 近年来,中国老年性黄斑变性(AMD)患病率不断上升,药物治疗手段快速发展,中国各地眼科医师对AMD的干预意识与知识的普及率有待提高,各地区各层级医院对AMD的诊断与治疗仍以自己的经验积累为主,需要规范化的诊断治疗临床路径。方法 中华医学会眼科学分会眼底病学组组成ldquo;中国老年性黄斑变性临床指南与临床路径制订委员会rdquo;,借鉴国际指南,通过系统的文献检索,对更新的临床研究证据进行分析,结合我国AMD类型的特殊性和目前社会经济发展现状,制订了ldquo;中国老年性黄斑变性临床诊断治疗路径rdquo;(以下简称ldquo;临床路径rdquo;),用于指导AMD的治疗。结果 本临床路径按AMD分期和分型,包括检查项目的选择、治疗手段、随诊和低视力辅助,以流程方式编写,便于眼科专科医生和眼科全科医生理解和掌握,有利于普及规范化的AMD诊断治疗临床路径。结论 中国老年性黄斑变性临床路径的制订遵循循证医学的基本原则,结合中国实际诊断治疗需求,对AMD的临床诊断治疗工作给予原则性的指导意见。本临床路径旨在满足大部分患者的诊断治疗需求,临床医生在应用本临床路径时还应当考虑患者的个体情况,根据病情、可选择的治疗方案、患者的经济承受能力等因素综合采用治疗措施。

Objectives The prevalence of age-related macular degeneration (AMD) is rising in China in recent years, and there are more and more drug treatment modalities for this disease. However, all over the country many ophthalmologists have only limited knowledge of prevention and intervention of AMD. In most hospitals the management of AMD is personal experience-based without consensus. It is urgent to propose a standardized clinical pathway for AMD in China. Methods The clinical guideline and clinical pathway development committee of AMD is established under the Chinese Ocular Fundus Diseases Society. The committee proposed the Chinese AMD clinical pathway (hereinafter referred to as quot;clinical pathwayquot;), based on existed international guidelines, and updated clinical research evidence, the specific types of AMD and the current socio-economic status in China. Results This clinical pathway was developed on the basis of the clinical stages and clinical types of AMD, including the choice of examination items, treatment Methods , follow-up and low vision aids. The clinical pathway was designed in flow sheets, which is easy to understand and implement for ophthalmologists, thus to standardize AMD clinical management procedures. Conclusions The clinical pathway, which followed the basic principles of evidencebased medicine and combined with the actual demands of patients with AMD in China, provides principle guidance for the diagnosis and treatment of AMD. The clinical pathway was designed to meet the requirements of the majority of AMD patients; clinicians should also consider individual situations of patients, available treatment options, the patient's affordability and other factors when making treatment decisions.

关键词: 黄斑变性/诊断; 黄斑变性/治疗; 临床路径

Key words: Macular degeneration; Macular degeneration; Critical pathways

引用本文: 中华医学会眼科学分会眼底病学组中国老年性黄斑变性临床指南与临床路径制订委员会. 中国老年性黄斑变性临床诊断治疗路径. 中华眼底病杂志, 2013, 29(4): 343-355. doi: 复制

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