中国消化外科抑酸药物规范化使用的临床实践指南(2022版)

Clinical practice guideline for appropriate use of gastric acid suppressants in gastrointestinal surgery(2022 edition)

抑酸药物,如质子泵抑制剂等,是临床上应用最广的一类药物。现阶段抑酸药物滥用问题普遍,每年造成巨大医疗资源浪费。而且大量研究发现长期使用抑酸药物可升高骨折、消化道感染等多种疾病的发病风险。世界各国都开始制定指南来规范抑酸药物的使用。消化外科是抑酸药物使用最多的科室之一,抑酸药物被大量应用于胃肠吻合术后消化道溃疡预防、消化道出血的治疗等。但许多临床用药都属于超适应证用药,缺乏证据支持,国内外亦无专门临床指南指导抑酸药物在消化外科的应用。因此,中国医师协会外科医师分会上消化道外科医师委员会、中国抗癌协会胃癌专业委员会联合发起制定本指南,旨在基于当前最佳研究证据,结合专家临床经验,为消化外科医师规范化使用抑酸药物提供指导意见,最终让患者获益。

Gastric acid suppressants,such as proton pump inhibitors,are one of the most widey used drugs worldwide.There is a very high frequency of abuse of gastric acid suppressants,leading huge waste of medical resources.Moreover,numerous studies have showed that acid suppressants were associated with a variety of adverse events,such as fractures and intestinal infections.Increasing guidelines and consensuses have been made to guide the appropriate use of acid suppressants.Gastrointestinal surgery is one of the fields with the largest prescriptions of acid suppressants.Acid suppressants are widely used for preventing anastomotic bleeding after upper gastrointestinal surgery,treating gastrointestinal bleeding and etc.However,most of these prescriptions are off-label uses lacking adequate evidentiary basis.Thus far,there is no guideline specific for appropriate use of acid suppressants in digestive surgeries.Therefore,Chinese Society of Upper Gastrointestinal Surgeons(CSUGS)and Chinese Gastric Cancer Association(CGCA)developed this clinical practice guideline based on the best research evidence and clinical expertise.The aim is to guide the appropriate use of gastric acid suppressants in gastrointestinal surgery,which in turn,increase the benefits of patients.