世界卫生组织《结核病整合指南模块5:儿童和青少年结核病管理》解读  

Interpretation of WHO consolidated guidelines on tuberculosis.Module 5:management of tuberculosis in children and adolescents

作　　者：樊丽超 焦伟伟 吴浩宇 申阿东 陈禹[1] Fan Lichao;Jiao Weiwei;Wu Haoyu;Shen Adong;Chen Yu(Department of Student and Child Tuberculosis,Shenyang Tenth People’s Hospital,Shenyang 110044,China;Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,National Key Discipline of Pediatrics(Capital Medical University),Beijing Pediatric Research Institute,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]沈阳市第十人民医院学生儿童结核科,沈阳110044 [2]国家儿童医学中心/首都医科大学附属北京儿童医院/北京市儿科研究所/儿科学国家重点学科/国家呼吸系统疾病临床医学研究中心/儿科重大疾病研究教育部重点实验室/儿童呼吸道感染性疾病研究北京市重点实验室,北京100045

出　　处：《中国防痨杂志》2023年第1期6-12,共7页Chinese Journal of Antituberculosis

基　　金：辽宁省自然科学基金(2022-MS-432)。

摘　　要：2022年3月21日,世界卫生组织(Word Health Organization,WHO)发布了WHO consolidated guidelines on tuberculosis.Module 5:management of tuberculosis in children and adolescents(简称《2022年版指南》),并通过发布的实施手册为指南建议的实施提供引导。《2022年版指南》基于最新循证医学证据对儿童和青少年结核病管理加以规范,并重点更新了儿童和青少年结核病启用Xpert Ultra作为初始诊断以及利福平耐药性检测工具,启用整合的治疗决策路径,非重症患儿启用疗程4个月的治疗方案,在6周岁以下耐多药/利福平耐药结核病(MDR/RR-TB)患儿中可启用含贝达喹啉的治疗方案,在3周岁以下MDR/RR-TB患儿中可启用含德拉马尼的治疗方案,结核性脑膜炎可启用疗程6个月的强化治疗备选方案,启用向基层下沉的非中心化的结核病关怀模式和家庭为核心的整合的结核病关怀模式等内容。笔者现对《2022年版指南》进行介绍,并对其更新要点加以解读,旨在基于循证依据为我国儿童和青少年结核病诊疗领域同道提供参考。On March 21,2022,the World Health Organization(WHO)published the WHO consolidated guidelines on tuberculosis.Module 5:management of tuberculosis in children and adolescents(2022 version Guideline),and provide guidance for the implementation of the guidance recommendations through the published implementation manual.The 2022 version Guideline standardizes the management of tuberculosis in children and adolescents based on the latest evidence-based medical evidence,and focuses on updating the use of Xpert Ultra as the initial diagnosis tool and rifampicin resistance detection tool for children and adolescents with tuberculosis;integrated treatment decision-making paths is enabled;4-month treatment program is enabled for non-severe children;treatment program containing bedaquiline is enabled for multidrug-/rifampicin-resistant tuberculosis(MDR/RR-TB)children under the age of 6;among MDR/RR-TB children under 3 years of age,the treatment plan with delamanid can be used;the option of intensive treatment with a course of 6 months can be used for tuberculous meningitis;and the decentralized tuberculosis care model sinking to the grass-roots level and the integrated tuberculosis care model with family as the core can be used.The author now introduces the 2022 version Guideline and interprets the updated key points,aiming to provide reference for staff in the field of tuberculosis diagnosis and treatment in children and adolescents based on evidence.

关 键 词：儿童 青少年 结核 总结性报告(主题) 

分 类 号：R52[医药卫生—内科学] R725[医药卫生—临床医学]