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复杂性双胎宫内干预技术应用进展
Advances in the application of intrauterine intervention techniques for complicated twin pregnancies
复杂性双胎指发生于单绒毛膜双胎妊娠中的一组严重并发症,其临床表型主要包括双胎输血综合征、选择性胎儿生长受限、双胎反向动脉灌注序列征、单绒毛膜单羊膜囊双胎妊娠等并发症。当前临床治疗方法包括胎儿镜下胎盘吻合血管激光凝固术、射频消融减胎术、微波消融减胎术等,并逐步涌现如人工智能辅助宫内治疗、机器人辅助手术等新兴治疗手段。复杂性双胎宫内干预后存活胎儿的神经发育预后亟需关注,建议构建系统化长期随访体系。未来,通过多学科协作模式的深化与创新性诊疗技术的融合,有望推动复杂性双胎妊娠管理向精准化、智能化方向发展。
Complicated twin pregnancies refer to a set of severe complications occurring in monochorionic twin pregnancies,whose clinical phenotypes mainly include twin-to-twin transfusion syndrome,selective fetal growth restriction,twin reversed arterial perfusion sequence,and monochorionic monoamniotic twin pregnancies. Current clinical treatment methods include fetoscopic laser occlusion of chorioangiopagous vessels,radiofrequency ablation and microwave ablation,and novel treatment approaches are gradually emerging, such as artificial intelligence-assisted intrauterine therapy and robot-assisted surgery. The neurodevelopmental prognosis of surviving fetuses after intrauterine intervention for complicated twin pregnancies requires urgent attention,and it is recommended to establish a systematic long-term follow-up system. In the future,through the deepening of multidisciplinary collaboration models and the integration of innovative diagnostic and therapeutic technologies,it is anticipated that the management of complicated twin pregnancies will advance towards precision and intelligence.
复杂性双胎 / 宫内干预技术 / 胎儿镜 / 超声引导 / 双胎并发症
complicated twin pregnancies / intrauterine intervention techniques / fetoscopy / ultrasound guidance / twin complications
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