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台湾经验:成功应用射频消融术治疗双胎反向动脉灌注序列中一胎的病例报告及文献复习。

A Taiwan's experience: A case report and review of literature of successful early intrauterine treatment with radiofrequency ablation in twin reversed arterial perfusion (TRAP) sequence.

机构信息

Malaysian Ministry of Health, Malaysia; Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.

Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2021 Jun;120(6):1394-1399. doi: 10.1016/j.jfma.2021.01.022. Epub 2021 Feb 11.

Abstract

Acardiac twin or twin reversed arterial perfusion (TRAP) sequence is a rare medical complication of Monozygotic twins. Taiwanese Obstetricians usually treat TRAP sequence conservatively. Occasionally, repeated amnio-reduction is performed to decompress the polyhydramnios caused by the TRAP sequence, even though there was no correction of the pathophysiologic mechanism. Radiofrequency ablation is a minimally invasive, percutaneous technique that can effectively obliterate blood supply to an acardiac twin to preserve and protect the pump twin. This recent technique has never been used before for the treatment of the TRAP sequence in Taiwan. This article reported the first-hand experience of acardiac twin management with RFA in Taipei Chang Gung Memorial Hospital.

摘要

无心双胎或双胎反向动脉灌注(TRAP)序列是单卵双胞胎的罕见医学并发症。台湾的产科医生通常对 TRAP 序列采取保守治疗。偶尔会进行重复的羊膜减少术,以减轻 TRAP 序列引起的羊水过多,但并没有纠正其病理生理机制。射频消融术是一种微创、经皮的技术,可以有效地阻断无心双胎的血液供应,从而保护有功能的泵血双胎。这项新技术在台湾以前从未用于治疗 TRAP 序列。本文报道了台北长庚纪念医院首例使用射频消融术治疗 TRAP 序列的经验。

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