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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.

DOI:10.3390/jcm14134738
PMID:40649121
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12251126/
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/12251126/814e5e688c4c/jcm-14-04738-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/12251126/1c29ddbe8592/jcm-14-04738-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/12251126/814e5e688c4c/jcm-14-04738-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/12251126/1c29ddbe8592/jcm-14-04738-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52e/12251126/814e5e688c4c/jcm-14-04738-g002.jpg

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本文引用的文献

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Fluid resuscitation strategy in patients with placenta previa accreta: a retrospective study.胎盘植入患者的液体复苏策略:一项回顾性研究。
Front Med (Lausanne). 2024 Sep 24;11:1454067. doi: 10.3389/fmed.2024.1454067. eCollection 2024.
2
Evidence-based surgery for cesarean hysterectomy secondary to placenta accreta spectrum: A systematic review.胎盘植入谱系疾病相关剖宫产子宫切除术的循证外科治疗:系统评价。
Eur J Obstet Gynecol Reprod Biol. 2024 Nov;302:155-166. doi: 10.1016/j.ejogrb.2024.09.012. Epub 2024 Sep 12.
3
Managing Placenta Accreta and Massive Hemorrhage: A Case Report on Anesthetic and Surgical Interventions.
胎盘植入和大出血的处理:麻醉与手术干预的病例报告
Cureus. 2024 Jul 8;16(7):e64071. doi: 10.7759/cureus.64071. eCollection 2024 Jul.
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Case report of pregnancy complicated by severe pulmonary hypertension from mitral stenosis and placenta accreta spectrum disorder: management of two life-threatening conditions.妊娠合并二尖瓣狭窄致重度肺动脉高压及胎盘植入谱系疾病的病例报告:两种危及生命情况的处理
Eur Heart J Case Rep. 2024 Jan 29;8(2):ytae055. doi: 10.1093/ehjcr/ytae055. eCollection 2024 Feb.
5
Management and Outcome of Women with Placenta Accreta Spectrum and Treatment with Uterine Artery Embolization.胎盘植入谱系疾病女性的管理与结局以及子宫动脉栓塞术治疗
J Clin Med. 2024 Feb 13;13(4):1062. doi: 10.3390/jcm13041062.
6
Perinatal outcomes comparison between neuraxial and general anesthesia in pregnant women with placenta accreta spectrum: a multicenter retrospective study.胎盘植入谱系疾病孕妇行椎管内麻醉与全身麻醉的围产结局比较:一项多中心回顾性研究。
J Anesth. 2024 Apr;38(2):167-178. doi: 10.1007/s00540-023-03287-0. Epub 2024 Feb 12.
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General anesthesia at cesarean section for placenta previa.前置胎盘剖宫产术中的全身麻醉。
J Anesth. 2024 Apr;38(2):291-292. doi: 10.1007/s00540-024-03313-9. Epub 2024 Feb 5.
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Int J Gynaecol Obstet. 2024 Mar;164(3):992-1000. doi: 10.1002/ijgo.15125. Epub 2023 Sep 19.
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