临床指南在实践中的困境
The predicament of clinical guidelines in practice

国内临床指南的制定和修订如雨后春笋，层出不穷。临床医生尽力研读这些指南，并尽量遵照执 行，但是在实践过程中发现了一些问题，如临床指南的制定和评估程序不规范，指南的可获得性、可行性不足， 指南执行与临床现实间存在差距等，提出来供大家讨论。
The development and revision of clinical guidelines in China has mushroomed. Clinical doctors do their best to study these guidelines and follow them as far as possible, but in the process of practice, some problems are found, for example, the formulation and evaluation procedures of the clinical guidelines are not standardized; the accessibility and feasibility of the guidelines are insufficient; and there is a gap between the implementation of the guidelines and clinical reality, etc. These are discussed in the article