双胎输血综合征激光治疗前后脐动脉血流指数的超声研究

Ultrasonographic study on fetoscopic laser for twin-twin transfusion syndrome

目的探讨双胎输血综合征胎盘血管吻合支激光阻断前后胎儿脐动脉血流指数的改变。方法对9例超声诊断双胎输血综合征孕妇行超声引导下胎盘血管交通支激光阻断术，观察手术前后胎儿脐动脉血流指数的改变。结果手术前后供血胎儿脐动脉搏动指数、收缩期峰值血流速度与舒张末期血流速度比值有明显改变，差异有统计学意义（均P〈0．01），而受血胎儿手术前后脐动脉阻力指数差异有统计学意义（P〈0．01）。结论超声观察胎盘血管吻合支激光阻断术前后脐动脉血流指数改变有助于临床判断手术疗效与预后。

Objective To investigate the clinical significance of fetal umbilical artery（UA） index changes in twin-twin transfusion syndrome （TTTS） after receiving fetoscopic laser ablation of chorioangiopagous vessels （FLCV）. Methods Nine cases of TTTS diagnosed by ultrasonography received FLCV operation guided by ultrasound. The changes of fetal umbilical artery index were analysed before and after operation. Results After FLCV, the umbilical artery index had significantly changed, especially in the donor fetus, the difference of PI, S/D bad statistically value（all P 〈0.01）. But the umbilical only RI of the recipient fetus had significantly changed（ P〈0.0l）. Conclusions The changes of umbilical artery index should be measured before and after FLCV operation by ultrasonography. Those changes will be helpful to determine the fetal prognosis.