Rychik Jack
The Children's Hospital of Philadelphia, Perelman School of Medicine, The University of Pennsylvania, Philadelphia, USA.
World J Pediatr Congenit Heart Surg. 2013 Jan;4(1):80-4. doi: 10.1177/2150135112456405.
Palliative care in congenital heart disease is relatively uncommon. A condition in which discussion of palliative care may occasionally arise is in the case of prenatal diagnosis of hypoplastic left heart syndrome. Prenatal diagnosis allows families to be counseled and educated about the anomaly and provides the opportunity for a conscious, deliberate choice between the options of pregnancy termination, interventional management after birth, or nonintervention with palliative care. Multiple factors contribute to the decision making. Despite the improved outcomes, palliative care is still considered a viable option by the congenital heart care provider community. In a large series of consecutive fetuses presenting with hypoplastic left heart syndrome, approximately 11% chose termination of pregnancy and 7% chose postnatal palliative care. As outcomes steadily improve, the threshold for discontinuing the viability of palliative care as an option will be reached.
先天性心脏病的姑息治疗相对少见。在左心发育不全综合征的产前诊断病例中，偶尔会出现关于姑息治疗的讨论。产前诊断使家庭能够就该异常情况接受咨询和教育，并为他们在终止妊娠、出生后进行介入治疗或采用姑息治疗不进行干预这几种选择之间做出有意识、慎重的决定提供了机会。多种因素影响决策。尽管治疗效果有所改善，但姑息治疗仍是先天性心脏病医疗服务提供者群体认为可行的选择。在一系列连续出现左心发育不全综合征的胎儿中，约11%选择终止妊娠，7%选择出生后进行姑息治疗。随着治疗效果稳步提高，将达到不再把姑息治疗作为一种可行选择的临界点。
