胎儿先天性心脏病的孕产管理： 当前挑战与现代医学的发展趋势

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先天性心脏病目前在儿童出生缺陷中占据首位，并仍然是儿童死亡的主要原因。据不同统计数据，儿童先天性心脏病的发病率差异较大，范围为每1000例活产儿中4至50例。由于严重先天性心脏病相对少见，并且过去缺乏跨学科合作，围产期心脏病学的研究往往局限于小规模病例系列或单中心研究。本综述的目的是分析现有文献中关于先天性心脏病胎儿及新生儿围产期管理的最新进展，包括胎儿期诊断的新方法、产前及分娩期管理策略，并提出改善医疗可及性的建议，同时明确未来研究方向。文献检索在电子数据库（PubMed、Google Scholar）中进行，使用的关键词及其组合（俄文和英文）包括：“врождённые пороки сердца / congenital heart defects”（先天性心脏病）、“ВПС / CHD”（先心病）、“фетальная кардиология / fetal cardiology”（胎儿心脏病学）、“внутриутробная визуализация / intrauterine imaging”（宫内影像学）、“фетальная хирургия / fetal surgery”（胎儿外科）。胎儿心脏病学诊断技术的快速发展、围产期母胎监测的改进以及宫内手术的进步，对“母亲-先天性心脏病新生儿”群体的妊娠过程及产后结局产生了重要影响。胎儿超声心动图和标准化产科筛查有助于更早发现受先天性心脏病影响的妊娠，并推动产前咨询方式的改进。此外，以围产期多学科家庭支持及分娩管理为核心的胎儿心脏病学护理标准化方案正在逐步推广应用。

作者简介

Irina O. Bedoeva

North-Ossetian State Medical Academy

编辑信件的主要联系方式.
Email: bestielal@rambler.ru
ORCID iD: 0009-0003-0232-9475

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Lika K. Pagieva

North-Ossetian State Medical Academy

Email: pagievalika@yandex.ru
ORCID iD: 0009-0002-7448-0994

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Medina T. Shamsueva

North-Ossetian State Medical Academy

Email: Shamsuevam@mail.ru
ORCID iD: 0009-0007-6853-9095

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Yulia P. Nemkova

N.I. Pirogov Russian National Research Medical University

Email: ulianemkova523@gmail.com
ORCID iD: 0009-0005-2784-980X

Student

俄罗斯联邦, Moscow

Milana M. Shigalugova

North-Ossetian State Medical Academy

Email: milanashigalugova07@gmail.com
ORCID iD: 0009-0009-5296-0920

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Bella I. Plieva

North-Ossetian State Medical Academy

Email: bellapl@mail.ru
ORCID iD: 0009-0004-7466-7809

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Mariya V. Kudzieva

North-Ossetian State Medical Academy

Email: kudzieva1@mail.ru
ORCID iD: 0009-0001-6082-5050

Student

俄罗斯联邦, 40 Pushkinskaya st, Vladikavkaz, 362025

Aleksey M. Kireychev

N.I. Pirogov Russian National Research Medical University

Email: KirAlex2000@yandex.ru
ORCID iD: 0009-0007-6486-9505

Student

俄罗斯联邦, Moscow

Darya E. Kanbekova

Bashkir State Medical University

Email: grilonova@gmail.com
ORCID iD: 0009-0003-9291-0537

Student

俄罗斯联邦, Ufa

Igor I. Abramov

Tula State University

Email: ai89190742045@yandex.ru
ORCID iD: 0009-0001-8556-1346

Student

俄罗斯联邦, Tula

Victoria V. Kortieva

Rostov State Medical University

Email: 220300viktoria@mail.ru
ORCID iD: 0009-0007-6491-760X

Student

俄罗斯联邦, Rostov-on-Don

Milena V. Ustinova

Kuban State Medical University

Email: gmilaaaaa@mail.ru
ORCID iD: 0009-0000-8528-5022

Student

俄罗斯联邦, Krasnodar

Zirifa M. Magomedova

Dagestan State Medical University

Email: miss.zirifa@yandex.ru
ORCID iD: 0009-0009-6945-8128

Student

俄罗斯联邦, Makhachkala

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Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».