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| 房坦循环产妇的麻醉管理进展 |
| Progress in anesthetic management of parturients with Fontan circulation |
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| DOI：10.12089/jca.2025.12.016 |
| 中文关键词: 房坦循环 产妇 麻醉方法 体外膜肺氧合 麻醉管理 |
| 英文关键词: Fontan circulation Parturient Anesthetic method Extracorporeal membrane oxygenation Anesthetic management |
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| 中文摘要: |
| 房坦（Fontan）手术是治疗复杂先天性心脏病的姑息性术式，可以改善复杂先天性心脏病患者的心输出量与氧合，让患有单心室心脏病的女性能够存活到生育年龄，然而围术期缺氧和血流动力学波动严重威胁母婴健康。体外膜肺氧合（ECMO）辅助房坦循环产妇在分娩期间维持充足的组织灌注与血流，进而提高母胎的生存率。本综述通过汇总近年来的文献，从房坦循环的病理生理、妊娠和分娩期间血流动力学的变化、不同麻醉方法对血流动力学的影响以及ECMO辅助的优势等方面总结分析，以期为房坦循环产妇的临床有效干预提供参考。 |
| 英文摘要: |
| The Fontan procedure is a palliative surgery for treating complex congenital heart diseases, which can improve cardiac output and oxygenation in patients with complex congenital heart diseases, enabling women with single-ventricle physiology to reach childbearing age. However, perioperative hypoxia and hemodynamic fluctuations may be catastrophic to both mother and fetus. Extracorporeal membrane oxygenation (ECMO) support enables parturients with Fontan circulation to sustain adequate tissue perfusion and blood flow during childbirth, thereby improving maternal and fetal survival outcomes. This review summarizes and analyzes the pathophysiology of Fontan circulation, hemodynamic changes during pregnancy and childbirth, the impact of different anesthesia methods on hemodynamic variables, and the advantages of ECMO support by summarizing recent literature, aiming to provide reference for effective clinical intervention in parturients with Fontan circulation. |
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