血液净化技术治疗儿童免疫性疾病的临床实践指南(2026年版)OA

Hemopurification demonstrates unique advantages in the treatment of immune-mediated diseases in children;however,there is a lack of systematic and comprehensive guidelines for pediatricians.The Extracorporeal Blood Purification Group and Hemodynamics Group,Pediatric Intensive Care Branch,Chinese Medical Doctor Association jointly organized domestic experts in pediatric critical care,nephrology,rheumatology,immunology,and evidence-based medicine.Following the specifications outlined in the World Health Organization(WHO)Handbook for Guideline Development and the Guiding Principles for Formulating/Revising Clinical Practice Guidelines in China(2022 Edition),a systematic literature search was conducted.The appraisal of guidelines for research and evaluation Ⅱ(AGREE Ⅱ)tool was used for systematic evaluation,multiple rounds of surveys were conducted to identify clinical questions,and grading of recommendations assessment,development and evaluation(GRADE)system was adopted to develop recommendation decision tables.Through multiple rounds of Delphi expert consultation and consensus meetings,recommendation statements were formulated and reported in accordance with the reporting items for practice guidelines in healthcare(RIGHT)standards.This guideline primarily addressed three clinical issues:therapeutic plasma exchange for immune-mediated diseases in children,immunoadsorption therapy for immune-mediated diseases in children,and hybrid hemopurification modalities for immune-mediated diseases in children.Based on 23 pieces of evidence,four recommendations were formulated,along with specific practical points.This guideline provides evidence-based rationale and operational standards for the rational application of hemopurification techniques in pediatric immune-mediated diseases,thereby further enhancing treatment safety and efficacy.