临床实践中的临床实践
I Bhorat1, E Buchmann2, K Frank3
1Subdepartment of Fetal Medicine, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. bhorat@worldonline.co.za.
概括
在脑 (CP) 诉讼中,基底和丘脑 (BGT) 脑损伤是复杂的. 伤害通常是随着突然的围产期哨兵事件 (PSE) 而发生的,由于需要快速分娩,预防变得具有挑战性.
科学领域:
- 神经学 神经学
- 围产儿医学 围产儿医学
- 医疗诉讼诉讼 医疗诉讼
背景情况:
- 基底和丘脑 (BGT) 缺氧缺血性脑损伤是南非脑 (CP) 诉讼中的一个重要问题.
- 这种损伤模式经常与围产期哨兵事件 (PSE) 相关,这种事件通常是突然的,不可预见的和不可预防的.
- 产前条件可以为胎儿做准备,增加从即使是轻微的缺氧侮辱中对BGT损伤的脆弱性.
研究的目的:
- 在CP诉讼中为BGT缺氧缺血性脑损伤提供共识反应.
- 分析BGT损伤和围产期哨兵事件 (PSE) 之间的关联.
- 讨论预防和病例审查的临床影响.
主要方法:
- 对BGT缺氧缺血性脑损伤的国际文献的综述.
- 对围产期哨戒事件 (PSEs) 典型发病和可预防性的分析.
- 检查导致胎儿脆弱性和受伤模式的因素.
主要成果:
- BGT模式损伤与突然发作的,不可预见的围产期哨兵事件 (PSEs) 密切相关.
- 由于产前病理的胎儿初始化可以增加对BGT损伤的易感性.
- 虽然通常是突然的,但BGT损伤不常见地会在≥1小时内随着胎儿心率逐渐恶化而发生.
结论:
- 防止BGT损伤需要从PSE发作到10-20分钟的分娩间隔,这在南非具有挑战性.
- 每个病例都需要对所有可用的临床信息进行全面的,多学科的审查,以获得公平的解决方案.
- 国际文献支持在CP诉讼中管理BGT缺氧缺血性脑损伤的共识方法.
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