胎儿先天性肺囊腺瘤的医学伦理学分析 [中文引用][英文引用]

目的 讨论胎儿先天性肺囊腺瘤有关的医学伦理学问题。方法 针对产前诊断为胎儿先天性肺囊腺瘤的父母亲设计问卷调查表，将其分为尚未出生的和出生后已施行手术的2组，从医学伦理学角度提出问题，并进行电话回访，所得数据进行统计学分析。结果 电话回访问卷共60份，其中有效问卷56份，有效问卷率为93.3%。从调查问卷中得出关于对胎儿干预或手术治疗持什么态度方面的结论，2组具有显著差异性（χ²= 26.6，P<0.005）。问卷中发现，生后已实施手术治疗的患者89.3%术后生活质量并未受影响，其父母认为患CCAM的胎儿可成活；而对尚未出生的患者，其父母有67.8%担心胎儿干预或手术治疗后患儿受影响，其父母50%认为患CCAM的胎儿不能成活，2组具有显著差异性（χ²= 19.2，P <0.005）。单从胎儿的早期干预或手术治疗这角度来做调查，发现2组无显著差异性（χ²= 0.1，P＞0.05）。结论胎儿干预或手术治疗作为一种新的医学治疗模式具有一定的风险。一方面，患疾病的胎儿生命受威胁，需要胎儿早期干预或手术治疗；另一方面，胎儿干预或手术治疗还不被人们所接受，所以医学伦理方面的问题成为胎儿干预或手术治疗所面临的主要问题。而对于大多数母亲而言，只要胎儿平安，她们愿意牺牲自己，故对于诊治的医务人员要权衡胎儿干预和治疗的利弊勇于接受挑战，客观地、专业地为胎儿的生命提供保障。

Objective To discuss the problems of medical ethics of Congenital cystic adenomatiod malformation （CCAM）. Method The questionnaires for parents were designed for prenatal diagnosis of fetal congenital cystic lung lesion, which was divided into the unborn group and operation group after birth. The question was from the point of view of medical ethics, and they were followed-up by telephone, all the data were statistically analyzed. Results 56 questionnaires were valid among all the 60 questionnaires, the effective rate is 93.3%.Two groups had different attitude about whether fetal intervention or operation treatment drawn from the survey (χ²= 26.6, P <0.005). The life quality of 89.3% patients who have been implemented operation treatment after birth was not affected according to questionnaires, Their parents think that the fetus can survive suffer CCAM. For patients not yet born, 67.8% parents worry about children were affected by fetal intervention or operation treatment, 50% of parents think that their fetus can not survive suffer CCAM, two groups had significant difference (χ²=19.2, P <0.005). The survey showed no difference between two groups only from the perspective of early intervention or operation treatment (χ²= 0.1, P > 0.05). Conclusions Fetal intervention or operation therapy as a new medical treatment mode has a certain risk. On the one hand, the life of the fetal is threatened by CCAM. On the other hand, fetal intervention or operation treatment is not accepted by people. So the problem of medical ethics has become a main problem of fetal intervention or operation treatment. For most women, they are willing to sacrifice themselves as long as their fetals are safety. Therefore, the medical staff should weigh the pros and cons of fetal intervention and treatment , and accept the challenge bravely, provide professional protection of fetal life objectively.