摘要
目的研究镜下激光凝固胎盘吻合血管术(FLOC)治疗双胎输血综合征(TTTs)的临床效果。方法选取2017年6月～2018年10月本院收治的TTTs患者7例作为研究对象,均行镜下激光凝固胎盘吻合血管术治疗,分析7例患者手术情况、术后情况,随访至妊娠结束,统计妊娠结局。结果本组7例TTTs患者,手术均顺利完成,术后总体胎死宫内发生率为11.76%;选择性胎儿生长受限(sIUGR)发生率为7.14%,双胎贫血-红细胞增多序列征(TAPS)发生率为11.76%;术后6例进入围产期,其中行剖宫产分娩5例,自然分娩1例;平均分娩孕周(34.26±3.31)周;供血儿活产率83.33%,受血儿活产率100%;供血儿出现2例新生儿轻度窒息,1例重度窒息;受血儿无窒息发生;受血儿平均体质量高于供血儿(P <0.05)。结论 FLOC治疗TTTs患者的效果良好,可有效提高胎儿存活率,改善妊娠结局,具有较高应用价值。
Objective To study the clinical effect of laser photocoagulation of placental anastomoses (FLOC) in the treatment of Twin-twin transfusion syndrome (TTTs). Methods Seven TTTs patients admitted to our hospital from June 2017 to October 2018 were selected as the research objects. All of them were treated by laser photocoagulation of placental anastomoses under the microscope. The operation and postoperative conditions of the 7 patients were analyzed, followed up to the end of pregnancy, and pregnancy outcomes were counted. Results The operation of 7 TTTs patients was successfully completed. The overall incidence of fetal intrauterine after operation was 11.76%. The incidence of selective fetal growth restriction (sIUGR) was 7.14%, and the incidence of twin anemia-polycythemia sequence syndrome (TAPS) was 11.76%. Six cases entered perinatal period after operation, of which 5 cases underwent cesarean section and 1 case underwent natural delivery. The average gestational age of delivery was(34.26±3.31)weeks. The live yield of donor and recipient infants was 83.33% and 100%, respectively. There were 2 cases of mild neonatal asphyxia and 1 case of severe asphyxia in the donor. No asphyxia occurred in the blood-receiving children. The average body mass of the recipient was higher than that of the donor (P < 0.05). Conclusion FLOC is effective in treating TTTs patients, which can effectively improve fetal survival rate and pregnancy outcome, and has high application value.
作者
赵丽娜
ZHAO Li-na(Department of Obstetrics, Henan People's Hospital, Zhengzhou, Henan, 450003, China)
出处
《临床研究》
2019年第5期4-6,共3页
Clinical Research
关键词
双胎输血综合征
镜下激光凝固胎盘吻合血管术
并发症
妊娠结局
twin-twin transfusion syndrome
endoscopic laser coagulation placental anastomosis
complication
pregnancy outcome
