双胎输血综合征研究现状及新进展

Current Status and Update on Twin-to-twin Transfusion Syndrome

双胎输血综合征(twin-twin transfusion syndrome,TTTS)是单绒毛膜双胎最常见的一种并发症。TTTS的发病机制尚不完全明确,胎盘间存在血管交通是其发病的必要条件,但它难以解释胎儿所有的病理生理,而内分泌改变为TTTS的发病机制提供了一种可能的解释。TTTS的临床诊断主要依靠超声。Quintero分期是目前使用最广泛的分期标准,但其不能提供预测信息,存在一定的局限性。治疗方面,选择性胎儿镜下激光消融术有着较好的胎儿存活率及神经系统预后,优于传统治疗方法,有较好的发展前景。

Twin-to-twin transfusion syndrome（TTTS） is the most common major complications in monochorionic pregnancy.The onset of TTTS contribute to the role of placental vascular connection.But simple blood transfer from the donor to the recipient twin cannot explain all of the pathological mechanism of TTTS.The endocrinology change may contribute a possible explanation.The diagnosis of TTTS mainly depends on the ultrasound features.The widely used Quintero staging system in the estimation of twin-to-twin transfusion syndrome is still controversial.The selective fetoscopic laser coagulation of anastomosing vessels is currently considered the best modality and nervous system prognosis of treatment.