产时外科诊治新进展及展望

New progress and prospects of intrapartum surgery

随着现代产前诊断技术的发展,大部分先天性畸形在胎儿期即可被诊断出来。若出生后再进行矫正,有些出生缺陷可能会急剧加重,甚至导致患儿死亡。产时外科是在胎盘循环下,即采取措施通畅胎儿呼吸道或直接进行畸形矫正,被认为是介于胎儿外科与新生儿外科之间的一项手术方式,是一项需要多个临床科室紧密合作,才能取得成功的新技术。产时麻醉技术在产时外科手术过程中起着关键作用。笔者拟就产时外科的临床适应证、产前诊断、产时麻醉技术要点、产妇并发症及新生儿预后等的最新研究进展进行阐述。

With the development of modern prenatal diagnostic techniques, most of congenital defects have already been diagnosed in the fetus period. Some birth defects may become more serious increasingly and can even lead to newborn deaths. By maintaining utero-placental circulation, the fetal airway can be secured or the defects can be corrected prior to delivery. Intrapartum surgery is a new technology which is between fetal surgery and newborn surgery and needs multidisciplinary close cooperation. Among that, anesthetic techniques play a key role. The article will review on its clinical indications, prenatal diagnoses, the key aspects of intrapartum anesthetic techniques, maternal complications and neonatal prognosis in detail.