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双胎输血综合征(twin-twin transfusion syndrome,TTTS)是单绒毛膜双胎最常见的一种并发症。TTTS的发病机制尚不完全明确,胎盘间存在血管交通是其发病的必要条件,但它难以解释胎儿所有的病理生理,而内分泌改变为TTTS的发病机制提供了一种可能的解释。TTTS的临床诊断主要依靠超声。Quintero分期是目前使用最广泛的分期标准,但其不能提供预测信息,存在一定的局限性。治疗方面,选择性胎儿镜下激光消融术有着较好的胎儿存活率及神经系统预后,优于传统治疗方法,有较好的发展前景。
Twin-twin transfusion syndrome (TTTS) is the most common complication of monochorionic twins. The pathogenesis of TTTS is not yet fully understood. The existence of vascular traffic between the placenta is a necessary condition for the pathogenesis of TTTS. However, it is difficult to explain the pathophysiology of the fetus. Endocrine changes provide a possible explanation for the pathogenesis of TTTS. The clinical diagnosis of TTTS mainly depends on ultrasound. Quintero staging is the most widely used staging standard, but it can not provide forecasting information and has some limitations. Treatment, selective fetal laser ablation has a good fetal survival and prognosis of the nervous system, better than the traditional treatment methods, have a good prospect.