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胎盘植入谱系疾病患者的麻醉管理:一项范围综述

Anesthetic Management for Patients with Placenta Accreta Spectrum: A Scoping Review.

作者信息

Jasinski Tomasz, Remesz Aleksander, Resko Rafal, Budynko Aleksandra, Majdylo Katarzyna

机构信息

Department of Anesthesiology and Intensive Therapy, Medical University of Gdansk, 80-210 Gdansk, Poland.

Department of Anesthesiology and Intensive Therapy, University Clinical Centre, 80-210 Gdansk, Poland.

出版信息

J Clin Med. 2025 Jul 4;14(13):4738. doi: 10.3390/jcm14134738.

Abstract

: Placenta accreta spectrum (PAS) is a condition in which villous tissue pathologically adheres to or invades the uterine wall, which may result in massive bleeding with substantial maternal morbidity and mortality. Despite the constantly increasing prevalence of this condition, an optimal anesthetic management method for this condition has not been fully established. A scoping review of the literature was performed to evaluate current anesthetic management strategies for PAS. : This review was conducted using the Joanna Briggs Institute (JBI) methodology for scoping reviews. A search of five databases (MEDLINE, EMBASE, CINAHL Complete, Scopus, and Web of Science) was conducted to identify articles containing data on seven prespecified aspects of PAS anesthetic management. Studies that described the management of miscarriage and abortion procedures were excluded. : One hundred thirty articles encompassing numerous approaches to PAS management were included in the final review. Data were mostly extracted from case reports (n = 56) and observational studies (n = 64). The most commonly adopted strategy (n = 62) was the creation of a multidisciplinary team comprising various specialists, including anesthesiologists. : Due to the limited number of interventional studies, the most effective methods of anesthetic management for this condition could not be fully established. However, the safe and effective anesthetic management of PAS patients is feasible. Future research in this field should focus on resolving the identified knowledge gaps and increasing the quality of published studies.

摘要

胎盘植入谱系疾病(PAS)是一种绒毛组织在病理上附着于或侵入子宫壁的病症,这可能导致大量出血,并使孕产妇出现较高的发病率和死亡率。尽管这种病症的患病率不断上升,但针对该病症的最佳麻醉管理方法尚未完全确立。我们进行了一项文献综述,以评估当前针对PAS的麻醉管理策略。

本综述采用乔安娜·布里格斯研究所(JBI)的综述方法进行。我们检索了五个数据库(MEDLINE、EMBASE、CINAHL Complete、Scopus和Web of Science),以识别包含PAS麻醉管理七个预先指定方面数据的文章。描述流产和堕胎手术管理的研究被排除。

最终综述纳入了130篇涵盖PAS多种管理方法的文章。数据大多来自病例报告(n = 56)和观察性研究(n = 64)。最常用的策略(n = 62)是组建一个由包括麻醉医生在内的各专科医生组成的多学科团队。

由于干预性研究数量有限,无法完全确立针对该病症最有效的麻醉管理方法。然而,对PAS患者进行安全有效的麻醉管理是可行的。该领域未来的研究应专注于解决已发现的知识空白,并提高已发表研究的质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/12251126/1c29ddbe8592/jcm-14-04738-g001.jpg

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