Sumikura Hiroyuki, Irikoma Shingo, Kondo Youichi, Hayashi Satoshi, Sago Haruhiko
Department of Anesthesia and ICU, National Center for Child Health and Development, Tokyo 157-8535.
Masui. 2010 Mar;59(3):338-46.
Recent advances in prenatal diagnosis have made fetal surgery as a possible treatment for a wide variety of fetal diseases. Fetal surgeries consist of minimally invasive fetal surgery such as ultrasound guided procedure and fetoscopic surgery, open fetal surgery, and ex-utero intrapartum treatment. Effectiveness of these fetal surgeries has been discussed and proved to be effective for some diseases. If a fetal surgery is planned, an anesthesiologist is required to offer optimal anesthesia both for mother and fetus. For this purpose, anesthesiologists are supposed to know outlines of the fetal treatment in addition to pediatric and obstetric anesthesia, as a member of multidisciplinary team. In this review, outlines of fetal treatment will be introduced and anesthetic considerations for fetal surgeries will be discussed.
产前诊断的最新进展使胎儿手术成为治疗多种胎儿疾病的一种可能方法。胎儿手术包括微创胎儿手术，如超声引导手术和胎儿镜手术、开放性胎儿手术以及宫外产时治疗。这些胎儿手术的有效性已得到讨论，并被证明对某些疾病有效。如果计划进行胎儿手术，需要麻醉医生为母亲和胎儿提供最佳麻醉。为此，作为多学科团队的一员，麻醉医生除了要了解儿科和产科麻醉外，还应知晓胎儿治疗的概况。在本综述中，将介绍胎儿治疗的概况，并讨论胎儿手术的麻醉注意事项。
