《中国克罗恩病诊治指南(2023年·广州)》解读

Interpretation of the Chinese Clinical Practice Guideline on the Management of Crohn's Disease(2023,Guangzhou)

中华医学会消化病学分会炎症性肠病学组于2023年制定了《中国克罗恩病诊治指南(2023年·广州)》,该指南在《炎症性肠病诊断与治疗的共识意见(2018年·北京)》基础上进行了修订及更新,引入循证团队,通过严谨的制定流程,对克罗恩病的诊断、治疗、围手术期管理、合并肛周病变的管理及疾病监测进行更系统的阐述,以期提高克罗恩病的规范化诊治水平。对比2018年《共识》,主要更新的内容包括:诊断标准及高危因素的再确认、无创检测手段的应用、达标治疗理念、多种生物制剂及小分子药物的选择、更为积极的肛瘘治疗方法、强调围手术期管理策略。本文通过查阅文献,结合前沿研究动态,分析并解读2023年《指南》与2018年《共识》相比的更新之处,并探讨其在临床实践中的应用。

The Inflammatory Bowel Disease Group of the Gastroenterology Branch of the Chinese Medical Association formulated and issued the Chinese Clinical Practice Guideline on the Management of Crohn's Disease(2023,Guangzhou).This guideline has been revised and updated on the basis of the Chinese Consensus on Diagnosis and Treatment in Inflammatory Bowel Disease(2018,Beijing).Through the engagement of an evidence-based team and a strict formulation process,the guideline covers the diagnostic methods,therapeutic regime,perioperative management,treatment of perianal lesions and disease surveillance of Crohn's disease,with an aim of standardizing the diagnosis and treatment of Crohn's disease.In comparison with the 2018 Consensus,the main updated contents included:reconfirmation of diagnostic criteria and high-risk factors,the application of non-invasive methods,the notion of"treat-to-target",selection of multiple biological agents and small molecule drugs,more aggressive management for anal fistula,as well as the importance of perioperative management.Through literature research,the present review interprets the abovementioned updates by comparing the recommendations in the 2023 Guideline with the previous consensus,and finally explores its application in clinical practice.