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胎儿手术对人类的急性心血管影响
Jack Rychik1, Zhiyun Tian, Meryl S Cohen
1Center for Fetal Diagnosis and Treatment and the Fetal Heart Program, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104, USA. rychik@email.chop.edu
Circulation
|September 9, 2004
概括
对于先天性异常的胎儿手术会导致急性心血管变化,包括心率增加和心脏输出量减少. 在产前干预期间,回声心脏图监测对于管理这些影响至关重要.
科学领域:
- 心血管生理学心血管生理学
- 胎儿医学 胎儿医学
- 手术创新 在外科创新.
背景情况:
- 对于先天性异常的产前手术可以改善结果,但其对心血管的影响尚不清楚.
- 胎儿外科手术的指示正在扩大.
- 了解急性心血管疾病的后果至关重要.
研究的目的:
- 在胎儿手术期间评估急性心血管变化.
- 评估不同先天性异常对胎儿手术心血管反应的影响.
- 确定心声回声学在监测这些变化的作用.
主要方法:
- 心声学用于在手术前,手术期间和手术后评估胎儿的心脏.
- 评估的胎儿经历了骨髓瘤修复,胸内切除,先天性隔膜修复,和神经皮瘤切除.
- 监测心率,心脏输出,中风体积,心室功能,膜功能和动脉管收缩.
主要成果:
- 所有胎儿在手术期间都经历了急性心血管变化,包括心率增加和心脏输出量减少.
- 胎儿有异常,如胸内质量,先天性隔膜,和神经皮瘤显示了先前存在的心血管问题.
- 在所有组中都观察到心室功能障碍,膜功能障碍和导管收缩;胎儿胸内质量和神经囊瘤的胎儿有最显著的变化.
结论:
- 胎儿手术期间的急性心血管变化是由于异常的生理学,手术压力,毒解药物和麻醉造成的.
- 声心图监测对于进行胎儿手术的患者的管理至关重要.
- 这些发现强调了心血管评估在胎儿干预中的重要性.
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