错过的机会:单一中心对产前心脏缓解护理的洞察
Hannah Tredway1, Katie Moynihan1, Hadley Bloomhardt2
1Department of Cardiology, Boston Children's Hospital, Boston, MA,; Department of Pediatrics, Harvard Medical School.
The Journal of pediatrics
|August 23, 2025
概括
对于严重先天性心脏病 (CCHD) 的产前缓解护理 (PC) 的使用不足,只有12%的患者接受咨询. 对于高风险的慢性心血管疾病病例的常规检查可以改善护理.
科学领域:
- 儿童心脏病学
- 缓和护理
- 新生儿医学
背景情况:
- 临界先天性心脏病 (CCHD) 具有显著的发病率和死亡率.
- 补救护理 (PC) 咨询可以改善共享决策并减少家庭压力.
- 目前使用产前PC治疗慢性心血管疾病的方法尚不清楚.
研究的目的:
- 对被诊断患有严重先天性心脏病 (CCHD) 的患者进行产前缓解护理的利用率进行评估.
- 确定与慢性心脏病患者早期诊断相关的因素.
- 评估高风险慢性心脏病患者是否需要定期的专家咨询.
主要方法:
- 在第三级中心对产前CCHD诊断 (2020-2023) 的回顾性研究.
- 收集关于初次住院,PC咨询时间和结果的数据.
- 定义为出生前或死亡前30天.
主要成果:
- 确诊了506例产前慢性心脏病;只有12% (n=61) 的患者接受过临床咨询,其中4例产前.
- 在基因诊断 (61%) 或非心脏异常 (61%) 的患者中,早期PC更为常见.
- 在接受复杂新生儿手术的患者中,有18%接受了PC咨询;其中12%的患者死亡.
结论:
- 孕前缓解性护理的使用率仍然很低.
- 建议对高风险的慢性心脏病患者进行例行医疗咨询,以加强护理.
- 改善PC整合可以支持慢性心脏病患者和面临复杂医疗旅程的家庭.
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