(精编)【医学教学课件】双胎输血综合征教学课件.pptVIP

LOGO;LOGO;;分裂发生在晚期囊胚，即受精后4~8日—— 形成双羊膜囊单绒毛膜单胎盘 ;COMPANY ;治疗方法;相对于保守治疗和羊膜腔穿刺引流羊水减量，胎儿镜下胎盘血管交通支凝 固术是针对TTTs的病因治疗，是最为有效和具挑战性的宫内治疗技术。 国际上公认胎盘血管交通支的胎儿镜下激光凝固术是最佳的治疗方法; 目前，激光凝固术治疗TTTS成为国际上多个胎儿医学中心的首选治疗方法，可使其中至少一个胎儿存活率达到75-80%. 但由于设备、技术的限制，目前也只有为数有限的几个医疗中心可以完成该手术。; ;胎儿镜; 手术通常在全身麻醉或局部麻醉下进行，在B超介导下，胎儿镜经腹进人羊水过多的羊膜腔内，在直视下找到胎盘血管交通支，通过胎儿镜上的激光纤维选用适当的功率凝固这些血管，手术最后同时进行羊水减量(500—1000 ml)。;胎儿镜下激光凝固术阻断TTTs胎盘血管吻合支进行中 ; This black and white photograph shows the areas of degeneration in the former vascular equator produced by the fetoscopic laser occlusion of the connecting (anastomotic) blood vessels. The placenta was symmetrically shared by the twins. The laser surgery was performed at 20 weeks, with the 4lb. 5oz. and 3lb. 14oz. twin boys born 12 weeks later.;Entering the uterus (womb) via laparoscopic instruments Looking at the Reciepient Twin Looking at the Donor Twin, or “Stuck Twin” - You will be able to see the membrane enveloping this twin Mapping the placenta for communicating (shared) vessels – You will see a red light (the guiding light) on the vesssels Lasering of the communicating vessels - You will see a blue light lasering the vessels Reviewing the lasered vessels - You will see white patches on the placenta Exiting the uterus;并发症及预防;谢谢观赏