产前超声诊断13例双胎反向动脉灌注序列征临床分析

Prenatal Ultrasound Diagnosis of 13 Cases of Twin Reversed Arterial Perfusion Sequence

目的探讨双胎反向动脉灌注序列征(TRAP)超声图像特征,以及影响泵血儿预后的因素。方法回顾性分析来我院超声科检查并确诊的13例TRAP临床资料,对超声图像特征及与泵血儿预后不良相关因素进行分析。结果 13例无心畸胎体内均可检出一条脐静脉和一条脐动脉。无心畸胎的脐动脉血流方向均为流向胎块。泵血儿预后不良主要受以下几方面影响:(1)泵血儿染色体异常;(2)泵血儿的心脏功能异常;(3)无心畸胎体内血流丰富;(4)无心畸胎体质量的增加;(5)无心畸胎结构的多少对泵血儿预后影响不大,但无心畸胎水肿的严重程度可能会对泵血儿预后产生影响。结论产前超声在TRAP的诊断、预后相关因素评估以及治疗中具有重要价值。

Objective To investigate the ultrasonic image characteristics of twin reversed arterial perfusion （TRAP） sequence and the influence factors of prognosis for the pump twin. Methods A retrospective study was cma-ied out of 13 TRAP cases diagnosed by the department of ultra- sound. The uhrasonic image characteristics and the influence factors of prognosis of the pump twin were analyzed. Results Umbilical vein and ar- tery was detected in the acmdiacus of 13 TRAP cases. The umbilical artery blood was found flowing toward the acardiacus. The influence factors of poor prognosis for the pump twin can be list as follows ： Cchromosome abnormality of the pump twin ; Cardiac dysfunction of the pump twin ; Rich blood flow in the pump twin ; Increased acardiacus weight ; Anatomical structure of the acmdiacus might have no important effect on the prognosis, however, the severity of edema for the acardiacus might affects the prognosis. Conclusion Prenatal ultrasound is of great significant in the diagno- sis, prognosis related factors evaluation and treatment of TRAP.