常见的三症综合征,它们对心脏的影响,以及护理中的伦理考虑
Katherine A Kosiv1, Mark R Mercurio1, John C Carey2
1Yale University, New Haven, Connecticut.
Current opinion in pediatrics
|August 8, 2023
概括
在三症症中,先天性心脏病的治疗已经进化了. 对三形状21的心脏手术改善了生存率,对三形状13和18的手术频率增加显示了生存率的上升,倡导共享决策.
科学领域:
- 医学遗传学 医学遗传学
- 心脏病学 心脏病学
- 儿科手术 儿科手术
背景情况:
- 先天性心脏病 (CHD) 常见于称为三症的染色体异常.
- 在三症性疾病中治疗心脏病已经取得了重大进展.
- 从历史上看,心脏手术的结果在 trisomy 21 (唐氏综合征) 已经大大改善.
研究的目的:
- 审查三症病中心脏病发病率.
- 为了比较心脏外科手术在三症21的历史与三症13和18的趋势.
- 讨论伦理方面的考虑,并提出共同的决策,用于三症13和18的CHD管理.
主要方法:
- 关于心脏病发病率和三症外科手术结果的文献综述.
- 对心脏手术趋势的历史分析.
- 对治疗争议的伦理分析.
- 制定一个共同的决策框架.
主要成果:
- 患有21型心脏病的心脏手术后的存活率显著提高,降低了发病率和死亡率.
- 心脏外科手术越来越多地在三形13 (帕图综合征) 和三形18 (爱德华兹综合征) 患者中进行,其生存率有所改善.
- 对13型和18型心脏病进行心脏手术的意愿存在变化,伴随着道德辩论.
结论:
- 治疗21型心脏病的治疗方法与13型和18型心脏病有相似之处.
- 医生和家长应该在以目标为导向的治疗计划上进行合作.
- 当心脏手术修复可行和有益时,应考虑心脏手术修复,平衡风险和益处.
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