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中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (05) : 510 -518. doi: 10.3877/cma.j.issn.1673-5250.2020.05.003

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双胎输血综合征的诊治及其对新生儿预后影响的研究现状
杨璇1, 唐军1,†()   
  1. 1. 四川大学华西第二医院儿科、出生缺陷与相关妇儿疾病教育部重点实验室，成都　610041
  • 收稿日期:2020-05-06 修回日期:2020-09-01 出版日期:2020-10-01
  • 通信作者: 唐军

Current status of diagnosis and treatment of twin-twin transfusion syndrome and its influence on prognosis of neonates

Xuan Yang1, Jun Tang1,†()   

  1. 1. Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2020-05-06 Revised:2020-09-01 Published:2020-10-01
  • Corresponding author: Jun Tang
  • Supported by:
    Construction Project of National Key Clinical Specialty (Pediatrics and Neonatal Specialty)(1311200003303)
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杨璇, 唐军. 双胎输血综合征的诊治及其对新生儿预后影响的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(05): 510-518.

Xuan Yang, Jun Tang. Current status of diagnosis and treatment of twin-twin transfusion syndrome and its influence on prognosis of neonates[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(05): 510-518.

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之一。目前对TTTS发病机制的研究主要集中在胎盘异常血管吻合，血浆中血管生成活性因子含量差异，以及导致TTTS发生相关的基因水平和表观遗传学研究。产前超声诊断是MCDA双胎妊娠及TTTS孕妇早孕期的重要评估手段。研究显示，TTTS的产前治疗措施中，胎儿镜下激光凝固术是延长胎儿胎龄、改善胎儿预后的有效措施。TTTS存活供血儿与受血儿的并发症存在差异，对胎儿采取不同产前治疗措施，新生儿预后亦存在差异。笔者拟就国内外近年对TTTS的发病机制、围生期诊断、治疗，以及对新生儿结局影响等研究现状进行阐述。

关键词: 双胎输血综合征, 单绒毛膜双羊膜囊, 双胎疾病, 围生期医护, 发病机制, 新生儿结局, 围生期治疗, 激光凝固术, 多胎产后代

Twin-twin transfusion syndrome (TTTS) is one of the serious complications of twin pregnancy with monochorionicdiamniotic (MCDA). Research on pathogenesis of TTTS mainly focuses on abnormal vascular anastomosis of placenta, differences of angiogenic factors in plasma, related gene levels and epigenetics of TTTS. Prenatal ultrasound is an important diagnosis method for twin pregnancy of MCDA and TTTS pregnant in the first trimester.Results of study show that fetal endoscopic laser coagulation is an effective measure to prolong gestational age of twin pregnancy fetuses and improve their prognosis. There are differences in complications between survival donors and recipients of TTTS, and different prenatal treatment methods also lead to different prognosis. In this paper, authors will focus on the latest research progresses on pathogenesis of TTTS, perinatal diagnosis, treatment, and impact on neonatal outcomes.

Key words: Twin-twin transfusion syndrome, Monochorionicdiamniotic, Diseases in twins, Perinatal care, Pathogenesis, Prognosis of neonates, Perinatal treatment, Laser coagulation, Multiple birth offspring
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