多普勒超声对双胎输血综合征外周血流变化的研究

双胎输血综合征（ＴＴＴＳ）近年来已越来越引起妇产科临床的关注。本文应用多普勒超声对１１例ＴＴＴＳ胎儿的外周血流进行评价，以探讨两胎儿间不同的血流动力学形式及对妊娠后期危险性预测，结果：１、供、受血儿脐动脉搏动指数（ＰＩ）值明显高于正常组（Ｐ＜０．０１）；２、外周动脉－降主动脉（ＤＡＯ）及大脑中动脉（ＭＣＡ）ＰＩ值和峰值（Ｖｍ）降低（Ｐ＜０．０１）；３、妊娠晚期受血儿充血性心衰加重时脐静脉出现搏动性血流及心内房室瓣返流，结论：外周血流多普勒频谱改变为ＴＴＴＳ的诊断和治疗提供了准确的资料，ＴＴＴＳ胎儿的多普勒超声监测有助于降低围产期死亡率

Fetal Peripheral Vascular Flow Doppler Ultrasound Studies in Twin-Twin Transfusion Syndrome

Twin-twin transfusion syndrome(TTTS)is a very insteresting issue of gynaecology and obsterics.Peripheral vascular flow patterns of 11 fetuses with TTTS were evaluated by Doppler ultrasound to study the different hemodynamic patterns between two fetuses and forecasted for the risk factors during late pregnancy.Results:1.The pulsating indexes(PIs)of umbilical artery for the donor and recipient fetuses of TTTS group were higher significantly than that of normal group(P<0 01).2.The PIs and peak systolic velocity of the peripheral artery descending aorta,ductus arteriosus and middle cerebral artery were decreased in TTTS group(p<0 01).3.The signs of umbilical venous pulsations and mitral tricuspid valve regurgitation were seen in the recipient fetuses with congestive heart failure during late pregnancy.Conclusion:The changes of peripheral vascular flow provided an important data for the diagnosis and treatment of TTTS,and Doppler ultrasound monitoring on the fetuses with TTTS may be useful for decreasing the mortality in preinatal period.