应用可弯曲羊膜镜治疗双胎输血综合征。
Flexible fetoscope in the treatment of twin-to-twin transfusion syndrome.
机构信息
Department of Urology, National Children's Medical Center & Shanghai Children's Medical Center, Shanghai, China.
Department of Obstetrics, Fetal Medicine Unit & Prenatal Diagnosis Center, Shanghai First Maternity and Infant Hospital, Shanghai, China.
出版信息
ANZ J Surg. 2021 Nov;91(11):2499-2502. doi: 10.1111/ans.17225. Epub 2021 Sep 28.
BACKGROUND
Twin-to-twin transfusion syndrome (TTTS) could be treated with fetoscopic laser photocoagulation. For patients with placenta located on the anterior wall of uterus, surgical procedures are difficult. To solve this problem, a flexible fetoscope was designed in our department.
METHODS
The flexible fetoscope was made up of polyurethane, fiberglass and stainless steel coils. The specular body was soft and could bend encountering obstacles, which reduced the possibility of injury to the fetus and placenta. The distal tip of the body could curve from -180° to +270° with the control of the handweel. Three pregnant women of TTTS with anterior placenta was operated with this instrument.
RESULT
All pregnant women were treated smoothly and gave live twins birth at term. Through angiography, it was demonstrated that the vascular connections on the surface had been coagulated.
CONCLUSION
The flexible fetoscope was a novel instrument in treating TTTS, especially for the anterior placenta.
背景
双胎输血综合征（TTTS）可以通过胎儿镜激光光凝术进行治疗。对于胎盘位于子宫前壁的患者，手术较为困难。为了解决这个问题，我们科室设计了一种柔性胎儿镜。
方法
柔性胎儿镜由聚氨酯、玻璃纤维和不锈钢丝线圈组成。镜面体柔软，可以在遇到障碍物时弯曲，减少对胎儿和胎盘损伤的可能性。通过手柄控制，镜体的远端尖端可以从-180°弯曲到+270°。我们用该器械对 3 例 TTTS 合并前置胎盘的孕妇进行了手术。
结果
所有孕妇均顺利完成手术并足月分娩活胎。通过血管造影显示，表面的血管连接已被凝固。
结论
柔性胎儿镜是治疗 TTTS 的一种新型器械，尤其适用于前置胎盘。
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