胎儿镜下选择性胎盘血管凝结术治疗双胎输血综合征的临床研究进展

Clinical Research Progress in the Treatment of Twin-Twin Transfusion Syndrome by the Selective Laser Coagulation of Placental Vessels

双胎输血综合征是单绒毛膜双羊膜囊妊娠可能出现的严重并发症之一,致死率高。治疗方案包括期待治疗、羊水减量术、胎儿镜下选择性胎盘血管凝结术等。胎儿镜下选择性胎盘血管凝结术在提高出生成活率、降低远期并发症方面具有独特的优势,已成为治疗双胎输血综合征的首选方案。但由于其存在流产、早产、胎膜早破等风险,如何做到早诊断、早治疗,从而提高成活率、降低远期并发症等日益受到国内外专家的关注。

Twin-twin transfusion syndrome（TTTS） is a serious complication of a monochoric diamniotic pregnancy that may occur, and it has high fatality. Treatments of TTTS include expectation treatment, reducing amniotic cavity puncture of the amniotic fluid and selective laser coagulation of placental vessels（SLCPV）, the present study showed that SLCPV has obvious advantage in improving the survival rate,reducing the long term complications and thus become the first choice of treatment for TTTS. But due to the risk of fetal abortion,premature delivery and premature rupture of fetal membranes, thus how to make early diagnosis, early treatment so as to improve the survival rate and reduce long-term complications has increasingly cause the attention of experts at home and abroad.