九例射频消融选择性减胎术的疗效及观察  

Efficacy and Observation of Radiofrequency Ablation Selective Fetal Reduction in Nine Cases

作　　者：彭良玉[1] 范翠芳[1] 杨菁[1] PENG Liang-yu;FAN Cui-fang;YANG Jing(Department of Obstetrics and Gynecology,Renmin Hospital of Wuhan University,Wuhan 430000,China)

机构地区：[1]武汉大学人民医院妇产科,430000

出　　处：《国际妇产科学杂志》2021年第4期395-398,共4页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨射频消融减胎术(radio frequency ablation,RFA)对复杂性多胎妊娠的疗效。方法:回顾性分析2017年4月—2019年5月在武汉大学人民医院行RFA治疗的9例患者的临床资料,总结其临床疗效,包括流产、早产、足月产、活产、分娩方式和新生儿体质量等。结果:9例患者中有2例是双绒毛膜三羊膜囊妊娠,有5例为单绒毛膜双羊膜囊双胎之一胎儿畸形行减胎术,1例为双胎输血综合征(twin-twin transfusion syndrome,TTTS)Ⅲ期减胎,1例为双胎之一选择性胎儿生长受限(selective fetal growth restriction,sFGR)Ⅱ型行选择性减胎术。9例患者均一次性RFA成功,手术成功率100%,均无手术并发症,仅1例于减胎术后2周流产,其余均获得活产。结论:RFA对复杂性多胎妊娠是一种安全有效且损伤小的宫内治疗方式,在临床上应该根据绒毛膜性及患者的意愿选择合适的减胎方式。Objective:To investigate the treatment effect of radio frequency ablation(RFA)on fetal reduction.Methods:The clinical data of 9 patients undergoing RFA for the fetal reduction in our hospital from April 2017 to May 2019 were retrospectively analyzed,including the average age of the patients,the number of pregnancies,the mode of pregnancy,the gestational weeks at the time of the fetal reduction,the indications of fetal reduction and the pregnancy outcome.The clinical efficacy was summarized,including abortion,premature delivery,full-term birth,live birth,mode of delivery,neonatal weight,etc.Results:Among the 9 cases,2 cases were dichorionic triamniotic(DCTA)triplet pregnancies,5 cases were monochorionic diamniotic(MCDA)twin conceived,which one of the twins underwent fetal reduction due to disorder fetal anomalies,1 case was twin transfusion syndrome(TTTS),and 1 case was one of the twins with selective fetal growth restriction(sFGR)typeⅡ.Nine pregnant women were operated successfully in a one-time RFA procedure.The procedure was technically successful in all cases.There were no operative complications.Only one case had miscarriage 2 weeks after the operation,and the rest gave birth to the newborns.Good pregnancy outcome was achieved and the clinical effect was significant.Conclusions:RFA is a safe,effective and minimally invasive intrauterine treatment for complicated multiple pregnancies,and the appropriate method of fetal reduction should be selected by chorionicity and patient′s willingness.

关 键 词：导管消融术 妊娠减少 多胎 妊娠 多胎 胎儿生长迟缓 双胎输血综合征 双生 射频消融减胎术 

分 类 号：R713[医药卫生—妇产科学]