双胞胎对双胞胎输血综合征:从病理生理学到长期结果 - - 一篇叙事性综述
Maëlig Abgral1,2, Grégoire Dumery3,4, Charles Mégier3,4
1Department of Obstetrics and Gynecology, DMU Santé Des Femmes Et Des Nouveau-Nés, Antoine Béclère Hospital, Paris Saclay University, AP-HP, Clamart, France. maelig.abgral@aphp.fr.
European journal of pediatrics
|December 17, 2025
概括
胎镜激光光凝血 (FLP) 显著改善双胞胎对双胞胎输血综合征 (TTTS) 的存活率. 然而,幸存者需要长期监测潜在的神经,心脏和脏并发症.
科学领域:
- 周围生理学 周围生理学
- 胎儿医学 胎儿医学
- 新生儿科学 新生儿科学
背景情况:
- 双胞胎对双胞胎输血综合征 (TTTS) 是单胞胎双胞胎怀孕的严重并发症.
- 胎镜激光光凝血 (FLP) 是TTTS的标准治疗方法,但新生儿的结果各不相同.
- 之前的研究表明,相比于氨基缩小,FLP可以提高存活率.
研究的目的:
- 对TTTS进行FLP后的即时,短期和长期新生儿结局进行审查.
- 为了比较选择性和所罗门FLP技术之间的结果.
- 为了确定TTTS幸存者的持续性疾病.
主要方法:
- 临床试验,队列研究和元分析的叙述性综述.
- 专注于生存,神经,心血管和脏的结果.
- 分析数据,比较选择性与所罗门FLP技术.
主要成果:
- FLP提高了生存率,80-90%的病例至少有一个幸存的双胞胎.
- 过早生育是常见的 (中位数在32-34周分娩).
- 在幸存者中出现短期脑损伤 (2-8%) 和长期神经发育障碍 (3-14%). 心血管并发症影响8%,而与预期管理相比,功能障碍减少.
结论:
- 在TTTS中,FLP显著提高了生存率.
- 新生儿发病率,包括神经,心脏和脏问题,仍然是一个令人担忧的问题.
- 多学科,长期的随访对于优化TTTS幸存者的结果至关重要.
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