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167例重度双胎输血综合征患儿接受宫内激光治疗后的长期神经发育结局

Long-term neurodevelopmental outcome of 167 children after intrauterine laser treatment for severe twin-twin transfusion syndrome.

作者信息

Graef Cornelia, Ellenrieder Birte, Hecher Kurt, Hackeloer Bernhard J, Huber Agnes, Bartmann Peter

机构信息

Department of Neonatology, Universitiy Childrens' Hospital, Bonn, Germany.

出版信息

Am J Obstet Gynecol. 2006 Feb;194(2):303-8. doi: 10.1016/j.ajog.2005.07.040.

Abstract

OBJECTIVE

This study was undertaken to investigate long-term neurodevelopmental outcome of children born after intrauterine laser coagulation for severe twin-twin transfusion syndrome.

STUDY DESIGN

One hundred sixty-seven surviving infants treated between June 1997 and September 1999 were investigated at a median age of 3 years and 2 months. All children underwent a detailed standardized physical and neurologic examination and a standardized developmental test (Griffiths' Developmental Test Scales and Snijders-Oomen Non-Verbal-Intelligence Test).

RESULTS

One hundred forty-five infants (86.8%) showed normal development, 12 infants (7.2%) showed minor neurologic abnormalities, and 10 infants (6.0%) major neurologic abnormalities. There was no difference in outcome for the former donors/recipients (P = .349) and between infants who were born as twins or singletons (P = .088).

CONCLUSION

With a high rate (86.8%) of normal neurodevelopmental outcome and an incidence of only 6.0% of major neurologic deficiencies, intrauterine laser coagulation seems to be the best treatment option for severe twin-twin transfusion syndrome.

摘要

目的

本研究旨在调查宫内激光凝固治疗严重双胎输血综合征后出生儿童的长期神经发育结局。

研究设计

对1997年6月至1999年9月间接受治疗的167名存活婴儿进行调查,中位年龄为3岁2个月。所有儿童均接受了详细的标准化体格和神经检查以及标准化发育测试(格里菲斯发育测试量表和斯奈德-奥门非语言智力测试)。

结果

145名婴儿(86.8%)发育正常,12名婴儿(7.)显示轻微神经异常,10名婴儿(6.0%)有严重神经异常。前供血儿/受血儿的结局无差异(P = 0.349),双胎或单胎出生的婴儿之间也无差异(P = 0.088)。

结论

宫内激光凝固治疗严重双胎输血综合征后出生儿童的神经发育结局正常率较高(86.8%),严重神经缺陷发生率仅为6.0%,似乎是最佳治疗选择。

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