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中华妇幼临床医学杂志(电子版) ›› 2017, Vol. 13 ›› Issue (05) : 497 -502. doi: 10.3877/cma.j.issn.1673-5250.2017.05.001

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双胎输血综合征的诊断与治疗现状及其临床困惑
徐婷婷1, 王晓东1, 刘兴会1,()   
  1. 1. 610041 成都,四川大学华西第二医院妇产科、出生缺陷与相关妇儿疾病教育部重点实验室
  • 收稿日期:2017-05-22 修回日期:2017-08-29 出版日期:2017-10-01
  • 通信作者: 刘兴会

Twin-twin transfusion syndrome: diagnosis, treatment and clinical confusions

Tingting Xu1, Xiaodong Wang1, Xinghui Liu1,()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2017-05-22 Revised:2017-08-29 Published:2017-10-01
  • Corresponding author: Xinghui Liu
  • About author:
    Corresponding author: Liu Xinghui, Email:
引用本文:

徐婷婷, 王晓东, 刘兴会. 双胎输血综合征的诊断与治疗现状及其临床困惑[J/OL]. 中华妇幼临床医学杂志(电子版), 2017, 13(05): 497-502.

Tingting Xu, Xiaodong Wang, Xinghui Liu. Twin-twin transfusion syndrome: diagnosis, treatment and clinical confusions[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(05): 497-502.

双胎输血综合征(TTTS)是单绒毛膜双羊膜囊(MCDA)双胎妊娠的严重并发症,主要由双胎之间胎盘血管交通支转运血液不均衡所致。TTTS的临床诊断及其分期,主要根据超声检查结果进行。孕妇孕龄为18~26孕周时,TTTS胎儿的病情可迅速发展,若未对其进行及时诊断和干预治疗,胎儿的围生期病死率较高。胎儿镜下介导胎盘交通血管激光凝固术,是治疗TTTS的有效方法,可明显改善妊娠结局,但仍然无法避免TTTS存活儿的近、远期并发症发生。

Twin-twin transfusion syndrome (TTTS) is one of the most frequent and severe complications of monochorionic diamniotic (MCDA) twin pregnancy. Vascular connections within a single placenta leading to the unbalanced transfer blood of twin is the main pathogenesis of TTTS. Clinical diagnosis and staging of TTTS mainly rely on ultrasonography. TTTS will develop rapidly during 18-26 gestational weeks and the perinatal mortality will be very high if it is not being diagnosed and treated timely. Fetoscopic laser photocoagulation of communicating vessels is an effective treatment method for TTTS. It can significantly improve the pregnancy outcomes of TTTS, while for survivors the near-term or long-term complications are still inevitable.

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