The neurological outcomes of surviving twins in severe twin-twin transfusion syndrome treated by fetoscopic laser photocoagulation at a newly established center
The neurological outcomes of surviving twins in severe twin-twin transfusion syndrome treated by fetoscopic laser photocoagulation at a newly established center
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DOI：
10.1002/pd.3929
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发表时间：
2012-09-01
影响因子：
3
通讯作者：
Wang, Chao-Nin
中科院分区：
文献类型：
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作者：
Chang, Yao-Lung;Chao, An-Shine;Wang, Chao-Nin
目的探讨胎儿镜下激光光凝(FLP)治疗双胎输血综合征(TTTS)存活者神经功能不良的发生率及预测因素。方法对接受FLP治疗的TTTS患者，在矫正年龄1岁时进行脑磁共振成像(MRI)和神经发育评估。严重神经异常被定义为存在严重的临床神经发育障碍或严重的异常，在脑部的MRI上可见。结果连续46例患者中，总存活率为66.3%，至少1例存活率为80.4%。重度神经发育障碍占6.7%(4/59)，脑影像严重异常占8.8%(5/57)，临床或MRI异常率为10.5%(6/57)。单变量分析显示，分娩时的早期胎龄是最显著的预测因素。然而，多元Logistic回归模型没有发现任何显著的变量。结论在这个小系列中，我们测定了1岁以下儿童的临床神经功能损失率为6.7%，与已发表的数据进行了比较。(C)2012年John Wiley&Sons，Ltd.
Objective To evaluate the incidence and predictive factors of poor neurological outcome in survivors of twin-to-twin transfusion syndrome (TTTS) treated with fetoscopic laser photocoagulation (FLP). Methods Brain magnetic resonance imaging (MRI) and neurodevelopmental assessment were performed at a corrected age of 1?year in survivors of TTTS treated by FLP. Severe neurological abnormality was defined as either the presence of severe clinical neurodevelopmental disability or severe anomalies, visualized on MRI of the brain. Result In a consecutive series of 46 cases treated by FLP, the total survival rate was 66.3%; survival of at least one was 80.4%. Severe neurodevelopment disability was 6.7 % (4/59) and the presence of a severe anomaly on brain imaging was 8.8% (5/57), which combined to a clinical or MRI abnormality rate of 10.5% (6/57). Univariate analysis revealed that early gestational age at delivery was the most significant predictor. However, the multiple logistic regression model did not identify any significant variables. Conclusion In this small series, we determined a rate of clinical neurologic impairment rate at the age of 1?year of 6.7%, which compares to what has been published. (c) 2012 John Wiley & Sons, Ltd.