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目的探讨胎儿脐静脉血流量(UVF)在产前评估双胎输血综合征(TTTS)中的应用价值。方法以22对产前诊断为TTTS双胎作为实验组,选取22对非TTTS的单绒毛膜双羊膜囊双胎(MCT)作为对照组。应用多普勒超声获取胎儿脐静脉血流频谱并测得此处胎儿脐静脉的横截面积,计算每个胎儿绝对的脐静脉血流量UVF、经体重校正的脐静脉血流量(UVF/kg)、每一对胎儿间UVF/kg的差值(ΔUVF/kg)、每一对胎儿间UVF/kg的比(R/D-UVF/kg)。对一对胎儿间及两组胎儿间脐静脉血流量参数进行比较。结果实验组受血儿与供血儿的脐静脉血流量差异及实验组和对照组的脐静脉血流量参数差异均有统计学意义(P<0.05)。实验组中受血儿的UVF和UVF/kg明显高于供血儿;实验组ΔUVF/kg和R/D-UVF/kg亦明显高于对照组。结论胎儿脐静脉血流量的差异反映了TTTS胎儿间不平衡的血流状态,有助于TTTS的产前诊断及评估。
Objective To investigate the value of fetal umbilical vein blood flow (UVF) in prenatal assessment of twin-tailed blood transfusion syndrome (TTTS). Methods Twenty-two prenatal diagnoses of TTTS twins were used as the experimental group, and 22 pairs of non-TTTS single chorionic twins (MCT) were selected as the control group. The fetal umbilical vein blood flow spectrum was obtained by Doppler ultrasound and the cross-sectional area of fetal umbilical vein was measured. The absolute umbilical vein blood flow (UVF), fetal weight-corrected umbilical vein blood flow (UVF / kg) , The difference in UVF / kg between each pair of fetuses (ΔUVF / kg), and the ratio of UVF / kg between pairs of fetuses (R / D-UVF / kg). A pair of fetuses and between two groups of umbilical blood flow parameters were compared. Results The differences of umbilical venous blood flow between the experimental group and the donor group and the umbilical venous flow parameters of the experimental group and the control group were statistically significant (P <0.05). The UVF and UVF / kg in the experimental group were significantly higher than those in the donor group; the experimental groups were significantly higher than those in the control group (ΔUVF / kg and R / D-UVF / kg). Conclusion The differences of fetal umbilical blood flow reflect the unbalanced blood flow status of TTTS fetuses and contribute to the prenatal diagnosis and assessment of TTTS.