超声评价双胎输血综合征“供血儿”的心功能改变

摘要

Objective To observe the value of 2D and color Doppler ultrasonography in assessing cardiac function of donor fetus in twin-twin transfusion syndrome (TTTS) pregnancies. Methods Seventeen TTTS pregnancies and 19 normal monochorionic diamniotic pregnancies (controls) were enrolled. Cardiac function of donor fetus and Doppler patterns of the umbilical artery, umbilical vein, ductus venosus and myocardial performance index of both ventricles were assessed. Results Absent or reversed diastolic blood flow in umbilical artery was found in 7 donor fetus. One donor fetus showed increased cardiothoracic ratio and pericardial effusion. Pulsatility index of the ductus venosus in donor fetus was significant higher than that of controls. Conclusion Mild cardiovascular abnormalities were found in donor fetus, and follow-up examination were helpful to the assessment of severity of this disease.%目的 探讨二维及彩色多普勒超声评价双胎输血综合征(TTTS)“供血儿”心功能的临床价值.方法 选择17例TTTS孕妇及19名正常单绒毛膜囊双羊膜囊双胎孕妇,测量脐动脉、脐静脉、静脉导管等血流频谱参数,计算胎儿心胸面积比值及心肌做功指数,重点分析“供血儿”的心功能改变.结果 TTTS“供血儿”中,7胎出现脐动脉舒张期血流缺失或反向,1胎发现心脏明显扩大并合并心包积液.“供血儿”静脉导管搏动指数明显高于正常胎儿.结论 TTTS“供血儿”已出现一定程度的心功能异常,动态监测心功能状况有助于判断TTTS严重程度,评价干预治疗的疗效.