Practical guidelines for the diagnosis, prevention and treatment of invasive fungal infection post burn injury in China: 2024 edition
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摘要: 烧伤患者是侵袭性真菌感染的高发人群。近年来,侵袭性真菌感染在烧伤人群中的发病率呈升高趋势,并日益成为严重烧伤患者死亡的重要原因之一。中国医疗保健国际交流促进会烧伤医学分会、《中华烧伤与创面修复杂志》编辑委员会共同发起并组织多学科专家,基于目前的循证医学证据、临床实践和其他学科权威指南,对《烧伤侵袭性真菌感染诊断与防治指南（2012版）》进行了修订,以期进一步规范烧伤侵袭性真菌感染的临床诊断与治疗。Abstract: Burn patients are at high risk for invasive fungal infections. The incidence of invasive fungal infection for burn victims is increasing dramatically during recent years and becoming one of the major causes of death in patients with severe burns. This updated guideline was initiated and organized by Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare, and Editorial Committee of Chinese Journal of Burns and Wounds. Based on the current evidence-based medical evidence, clinical practice, and authoritative guidelines from other disciplines, we updated and revised the Guidelines for the diagnosis, prevention and treatment of invasive fungal infections post burn injury (2012 edition), aiming to further standardize the diagnosis, prevention and treatment of invasive fungal infection post burns.
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Key words:
- Burns /
- Invasive fungal infections /
- Diagnosis /
- Clinical protocols /
- Guideline
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参考文献
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图 1 《烧伤侵袭性真菌感染诊断与防治实践指南（2024版）》专家推荐意见信息路径图
注：IFI指侵袭性真菌感染《烧伤侵袭性真菌感染诊断与防治实践指南（2024版）》编写组首席专家：罗高兴、袁志强[陆军军医大学（第三军医大学）第一附属医院全军烧伤研究所]专家组成员（单位名称以拼音排序,姓名以姓氏笔画排序）：安徽医科大学第一附属医院烧伤科徐庆连,海军军医大学第一附属医院烧伤外科王光毅、唐洪泰,河北医科大学第三医院烧伤与创面修复中心张庆富,吉林大学第一医院烧伤外科于家傲,暨南大学附属广州红十字会医院烧伤整形科李孝建,江南大学附属医院烧创伤诊疗中心吕国忠,解放军总医院第四医学中心烧伤整形医学部申传安,解放军总医院医学创新研究部转化医学研究中心姚咏明,兰州大学第二医院烧伤整形与创面修复外科刘毅,陆军军医大学（第三军医大学）第一附属医院全军烧伤研究所李海胜、周俊峄、罗高兴、袁志强、彭毅志,陆军军医大学（第三军医大学）第一附属医院药剂科孙凤军,陆军军医大学基础医学院微生物学教研室乐率,南方医科大学第十附属医院烧伤整形外科周军利,南通大学附属医院烧伤整形外科张逸,山东第一医科大学第一附属医院（山东省千佛山医院）烧伤与创面修复外科王一兵,上海交通大学医学院附属瑞金医院灼伤整形科刘琰,深圳大学第一附属医院烧伤整形科吴军、郇京宁,首都医科大学附属北京积水潭医院烧伤科沈余明,首都医科大学附属北京儿童医院烧伤整形科齐鸿燕,武汉大学同仁医院暨武汉市第三医院烧伤科谢卫国,浙江大学医学院附属第二医院烧伤与创面修复科韩春茂,郑州市第一人民医院烧伤科夏成德,《中华烧伤与创面修复杂志》梁光萍,中南大学湘雅医院烧伤整形外科张丕红,中山大学附属第一医院烧伤与创面修复科谢举临
Table 1. 基于GRADE评估体系的推荐强度及证据质量等级描述
项目与类别 描述 推荐强度 强推荐 强烈推荐采用 中等推荐 一般推荐采用 弱推荐 结合临床审慎采用 证据质量等级 高等级 专家组成员非常有信心,未来研究的结果不太可能会改变对效果估计的信心 中等级 专家组成员有适度的信心,效果估计反映了真实的效果,但有可能会改变 低等级 专家组成员的信心有限,效果估计很可能是不确切的,并且未来的研究很可能会改变对效果的理解 极低等级 专家组成员对效果估计几乎没有任何信心 注：GRADE指推荐意见分级的评估、制订和评价 
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Table 2. 烧伤侵袭性真菌感染诊断分级及标准
诊断分级 易感因素 临床特征 实验室检查 血液/无菌组织培养或组织学检查 确诊 ± ± ± 2项中一项为+ 临床诊断 + + + 2项均为- 拟诊 + + - 2项均为- 注：“+”表示符合该项标准,“-”表示不符合该项标准,“±”表示对应的诊断分级与是否符合该项标准无关
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