14例新生儿双胎输血综合征临床超声影像观察研究

目的评价超声诊断双胎输血综合征应用价值;探讨新生儿双胎输血综合征临床表现及合并症等问题。方法应用二维及多普勒超声测定14例22～36周的双胎妊娠胎儿生长指标及脐动脉血流PI值、RI值、S/D值,观察活产和死胎所产双胎婴儿供血儿和受血儿的各项指标。结果超声诊断双胎输血综合征14例,诊断准确率92.8%（13/14）,双胎输血综合征具有一般双胎的临床共性,其中受血儿出现病理临床表现及合并症较供血儿多且严重。结论二维联合多普勒超声诊断双胎输血综合征有较高的准确率,是快捷诊断双胎输血综合征手段之一。双胎输血综合征对受血儿危害更大,临床一旦确诊为双胎输血综合征,应对受血儿进行严密监护,若出现临床表现并发红细胞增多症,应积极采取治疗措施以减少严重并发症及后遗症的发生。

Studies of 14 twin-to-twin transfusion syndrome by ultrasound

Objective：To evaluate the applicated value of ultrasonic diagnosis on TTTS;To explore the clinical manifestation and complications of TTTS.Methods：With 2-Dimensional and Doppler ultrasound,we determined 14 cases of fetuses that were twin pregnanies in 22-36 weeks and the indexes were growth,PI,RI and S/D.We observed each index of fetuses（blood-supply and blood-accept）who were dead-birth and live-birth.Results：14 cases of TTTS were diagnosed with ultrasond and exact rate were 92.8%（13/14）.TTTS has common phenomenon with usual twin pregnancy and fetus blood-accept has more serious clinical manifestation and complications with that of blood-supply.Conclusions：To diagnose TTTS,2-Dimensional associated with Doppler ultrasound had higher exact rate and it was one of the shortcut methods of TTTS diagnosis.TTTS hurts blood-accept fetuses more and they must be monitorred closely.If there comes to erythrocytosis,therapeutic measure should be adoppted to decrease serious complications.