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双胎输血综合征(TTTS)是双胎妊娠中的一种严重的并发症,其围产儿死亡率极高。胎儿镜下激光凝固胎盘吻合血管术(FLOC)的诞生给TTTS的治疗带来了光明的前景,其疗效远优于羊水减量法,总生存率已达70%-80%。对FLOC手术指征的严格把握,术前对疾病分期的准确评估,胎盘造影术的运用,是有效降低FLOC手术失败发生率的关键。宫颈环扎术的运用和FLOC技术的改进,使宫颈短和有前置胎盘的TTTS患者同样有机会进行FLOC治疗。FLOC术后的早期预测及再次手术干预,是改善术后远期预后的关键。
Twin twin transfusion syndrome (TTTS) is a serious complication of twin pregnancy and has a high perinatal mortality rate. Fetal laser coagulation placental anastomosis (FLOC) was born to the treatment of TTTS has brought a bright future, its efficacy is far superior to the amniotic fluid reduction method, the overall survival rate has reached 70% -80%. Strict control of FLOC indications, preoperative accurate assessment of disease staging, and the use of placental angiography are the keys to effectively reducing the incidence of FLOC surgery failure. Cervical cerclage and the use of FLOC technology improvements, so short cervix and placenta previa TTTS patients have the same opportunity for FLOC treatment. Early prediction of FLOC surgery and re-operative intervention is the key to improve long-term postoperative prognosis.