慢性酒精相关性脑损害的中国诊疗指南(2024)

China guidelines on the diagnosis and treatment of chronic alcohol-related brain damage

慢性酒精相关性脑损害(ARBD),既往也称为慢性酒精中毒性脑病,是一组由长期酒精摄入导致人大脑慢性损害的重要疾病谱,它的起病和进展加重非常隐匿,及时、准确的诊断和处理有助于改善患者的临床预后,也减少社会的疾病负担。本指南经过文献查阅、循证证据的更新,根据证据推荐分级的评估、制订与评价(GRADE)方法制订指南初稿,并经过反复讨论和修改,最终形成中国慢性酒精相关性脑损害的诊断和治疗指南。本指南对比慢性ARBD各种临床综合征在不同诊断分类系统中的定义,对诊断慢性ARBD的各类辅助检查、筛查方法和诊断标准进行分级评价和推荐,并对戒酒、病因治疗、纠正营养失调、脑保护治疗和康复护理综合治疗等有助于改善慢性ARBD临床预后的各种干预治疗手段进行分级评价和推荐,共形成了28条推荐意见,为提高慢性ARBD的临床疗效提供参考和指导。

Chronic alcohol-related brain damage(ARBD),previously known as chronic alcoholic encephalopathy,is an important spectrum of chronic brain damage caused by long-term alcohol intake.Its onset and progression are very insidious.Timely and accurate diagnosis and treatment can help improve the clinical prognosis of patients and reduce the disease burden of society.After reviews of the literature and updating of evidence-based evidence,the draft guideline was developed according to the method of Grading of Recommendations,Assessment,Development and Evaluation(GRADE).After repeated discussions and revisions,a guideline on the diagnosis and treatment of chronic alcohol-related brain damage in China was finally established.This guideline compares the definitions of various clinical syndromes of chronic ARBD in different diagnostic classification systems,and grades and recommends various auxiliary examinations,screening tests and diagnostic criteria for the diagnosis of chronic ARBD.In addition,various intervention treatments that can improve the clinical prognosis of chronic ARBD,such as alcohol withdrawal,etiological treatment,correction of nutritional disorders,neural protection treatment,and rehabilitation with nursing comprehensive treatment,were graded and recommended.A total of 28 recommendations were formed to provide reference and guidance for improving the clinical efficacy of chronic ARBD.