Koj puas muaj menyuam ntxaib? Koj puas paub txog qhov mob txaus ntshai no? (Twin-to-Twin Transfusion Syndrome - TTTS)

Yog tias koj yog ib leej niam uas yuav muaj menyuam ntxaib, ua ntej tshaj plaws, thov ua tsaug! Txawm li cas los xij, nws tseem ceeb heev uas yuav tsum paub txog cov mob tshwj xeeb uas qee zaum tuaj yeem tshwm sim rau cov menyuam ntxaib. Ib qho mob uas tsis tau xav txog tab sis tsim nyog paub txog yog Twin-to-Twin Transfusion Syndrome , tseem hu ua TTTS luv. Tsis txhob txhawj, cia peb tham txog nws yooj yim.

Kab mob ntshav ntawm ob tug menyuam ntxaib (TTTS) yog dab tsi? Hais yooj yim xwb...

Xav txog tias ob tug menyuam ntxaib hauv koj lub tsev menyuam muaj tib lub tsev menyuam . Peb hu cov menyuam ntxaib no (monochorionic twins) . Feem ntau, ob tug menyuam tau txais cov ntshav thiab cov as-ham zoo ib yam los ntawm lub tsev menyuam no. Txawm li cas los xij, hauv qhov no (TTTS), qhov kev faib ntawd tsis tshwm sim kom raug.

Hais yooj yim xwb, ib tug me nyuam (peb hu nws ua 'tus ntxaib pub' ) tsis tau txais ntshav txaus los ntawm lub placenta. Tus me nyuam lwm tus (peb hu nws ua 'tus ntxaib txais' ) tau txais ntshav ntau dhau. Qhov kev tsis sib npaug ntawm cov ntshav ntws no yog qhov ua rau muaj TTTS. Qhov no yog ib qho mob tsis tshua muaj tab sis tej zaum yuav loj heev. Kev saib xyuas ze los ntawm tus kws kho mob Maternal-Fetal Medicine (MFM) yog qhov tseem ceeb. Kev kuaj pom thaum ntxov, kev saib xyuas, thiab kev kho mob tuaj yeem ua rau ob tus me nyuam muaj txiaj ntsig zoo dua.

Ua li cas rau 'tus menyuam ntxaib pub dawb'?

Tus me nyuam tau txais ntshav tsawg dua los ntawm lub placenta. Yog li, cov ntshav hauv nws lub cev kuj txo qis. Qhov no tuaj yeem ua rau tus me nyuam loj hlob qeeb, thiab cov kua amniotic nyob ib puag ncig nws kuj tseem yuav txo qis. Qhov no yog vim tus me nyuam tso zis tsawg dua. Qhov no yog vim cov kua amniotic feem ntau yog ua los ntawm tus me nyuam cov zis. Thaum cov kua amniotic txo qis, lub hnab uas tuav tus me nyuam tuaj yeem ntsws, lossis ploj mus. Qhov no txaus ntshai, vim tus me nyuam tsis tuaj yeem txav mus los zoo, thiab txoj hlab ntaws yuav raug nias.

Yuav ua li cas rau 'tus neeg tau txais ntxaib'?

Tus me nyuam no tau txais ntshav ntau dua li nws yuav tsum tau. Cov ntshav ntxiv no ua rau lub plawv ntawm tus me nyuam ntxhov siab heev, thiab tuaj yeem ua rau lub plawv tsis ua haujlwm . Thaum tus me nyuam pub mis tsis txaus noj, tus me nyuam txais mis yuav tsum ua haujlwm hnyav dua. Vim tias tus me nyuam no yuav tsum tau ua kom cov ntshav ntau dua, nws tso zis ntau dua li niaj zaus. Yog li ntawd, nws lub hnab amniotic loj dua.

Tus mob no (TTTS) cuam tshuam rau leej twg?

TTTS tsuas yog cuam tshuam rau cov cev xeeb tub uas cov menyuam ntxaib sib koom ib lub placenta (monochorionic) , thiab zoo ib yam (cov menyuam ntxaib zoo ib yam). Feem ntau, cov menyuam ntxaib uas muaj TTTS no muaj ob lub hnab amniotic sib cais (diamniotic). Peb hu cov menyuam ntxaib no (monochorionic diamniotic twins) .

Txawm li cas los xij, tsis tshua muaj tej zaum uas ob tug me nyuam sib koom tib lub placenta thiab amniotic sac (monoamniotic). Hauv cov xwm txheej zoo li no, TTTS kuj tuaj yeem tshwm sim. Txawm li cas los xij, cov menyuam ntxaib zoo li no tsis tshua muaj.

TTTS tuaj yeem tshwm sim thaum cev xeeb tub lig npaum li cas?

Feem ntau tus mob no yuav pib tshwm sim thaum ntxov li ntawm 16 lub lis piam, tab sis nws tuaj yeem tshwm sim txhua lub sijhawm thaum cev xeeb tub.

Muaj pes tsawg tus neeg mob (TTTS)?

TTTS tshwm sim hauv kwv yees li 15% ntawm cov cev xeeb tub monochorionic.

Cov tsos mob ntawm TTTS yog dab tsi?

Feem ntau cov niam uas muaj TTTS tsis muaj cov tsos mob tshwj xeeb. Txawm li cas los xij, qee tus yuav muaj cov tsos mob no:

• Zoo li lub tsev menyuam loj hlob sai dua li qhov xav tau.
• Xav tias mob los yog nruj hauv plab.
• Qhov hnyav nce sai sai.

Yog koj muaj cov tsos mob no, koj yuav tsum mus ntsib koj tus kws kho mob tam sim ntawd.

Dab tsi ua rau TTTS?

Feem ntau, thaum cev xeeb tub ntxaib uas muaj ib lub tsev menyuam xwb, ob tug menyuam yuav muaj cov ntshav los ntawm lub tsev menyuam sib npaug zos. Txawm li cas los xij, thaum cev xeeb tub nrog ib lub tsev menyuam, cov hlab ntsha hauv lub tsev menyuam yuav sib txuas ua rau cov ntshav faib tsis sib npaug zos. Ib tug menyuam (tus menyuam uas tau txais) tau txais ntshav ntau dua, thiab lwm tus menyuam (tus menyuam uas pub) tau txais ntshav tsawg dua.

Koj tswj tsis tau qhov uas lub placenta loj hlob tuaj. (TTTS) yog ib qho xwm txheej uas tshwm sim tsis tau xav txog. Nws tsis yog ib yam dab tsi uas koj tau ua lossis tsis tau ua. Yog li ntawd, tsis txhob liam koj tus kheej. (TTTS) tsis yog ib yam dab tsi uas tiv thaiv tau.

Leej twg muaj feem yuav raug tus kab mob (TTTS) no?

Qhov no tsis muaj kev sib txuas ntawm caj ces lossis kev xeeb tub los ntawm noob caj ces. Nws yog ib qho xwm txheej tshwm sim tsis tu ncua. Txawm li cas los xij, qhov no tsuas yog tshwm sim rau cov menyuam ntxaib uas muaj ib lub placenta (monochorionic) .

Cov teeb meem uas yuav tshwm sim los ntawm TTTS yog dab tsi?

Yog tias tsis kho, lossis yog tias qhov mob tshwm sim thaum ntxov ntawm cev xeeb tub, TTTS tuaj yeem ua rau muaj teeb meem loj rau tus menyuam, thiab tuaj yeem ua rau tuag taus. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob lossis saib xyuas ze ntawm tus kws kho mob tshwj xeeb rau niam thiab menyuam hauv plab (MFM specialist) lossis chaw saib xyuas menyuam hauv plab. Txawm tias kho tau sai, muaj kev pheej hmoo ntawm kev poob menyuam.

Lwm yam teeb meem uas feem ntau tshwm sim nrog TTTS suav nrog:

• Cov teeb meem los ntawm kev yug ntxov (xws li ua pa nyuaj, teeb meem ntawm lub paj hlwb).
• Tus menyuam ntxaib uas tau txais kev pab yuav muaj teeb meem plawv tsis ua haujlwm lossis lwm yam teeb meem plawv vim yog cov kua dej ntxiv.
• Tus menyuam ntxaib pub dawb yuav muaj teeb meem kev loj hlob qeeb lossis teeb meem raum.

Yuav kuaj mob TTTS li cas?

Koj tus kws kho mob ua ntej yug menyuam yuav kuaj mob TTTS los ntawm kev siv lub tshuab ultrasound . Thawj qhov uas tus kws kho mob yuav pom ntawm daim ntawv scan yog tias muaj ob tug menyuam ntxaib zoo sib xws sib koom tib lub tsev menyuam.

Yog tias koj xav tias muaj TTTS, koj tus kws kho mob yuav xa koj mus rau tus kws kho mob tshwj xeeb rau niam thiab menyuam hauv plab (MFM specialist) kom kuaj ntxiv.Nyob ntawd, tus kws tshwj xeeb yuav pom ib lossis ntau yam ntawm cov no ntawm kev ntsuas ultrasound:

• Qhov sib txawv ntawm qhov loj ntawm ob tug menyuam.
• Ib tug me nyuam muaj kua amniotic ntau dhau, thaum lwm tus me nyuam muaj kua amniotic tsawg dhau.
• Cov ntshav ntws tsis zoo hauv cov menyuam mos (qhov no tuaj yeem pom nrog Doppler ultrasound test).

Muaj tej lub sij hawm, yuav tsum tau kuaj MRI ntawm lub cev me nyuam hauv plab (fetal MRI) thiab kuaj echocardiography (echo) ntawm lub cev me nyuam hauv plab .

Koj pab neeg saib xyuas koj tus menyuam ua ntej yug menyuam yuav saib xyuas koj zoo thoob plaws koj cev xeeb tub. Tej zaum koj yuav tsum tau kuaj ultrasound ntau zaus kom paub tseeb tias tus menyuam noj qab haus huv zoo li cas.

Tus kws kho mob kuj tseem yuav kuaj xyuas koj txoj kev noj qab haus huv. Qee zaum, cov kua amniotic ntxiv rau sab ntawm tus neeg tau txais kev pab tuaj yeem ua rau koj lub tsev menyuam loj dua thiab koj lub qhov ncauj tsev menyuam qaug zog. Cov kev hloov pauv no kuj tseem tuaj yeem ua rau yug ntxov.

Cov theem ntawm (TTTS) yog dab tsi?

Kev siv ultrasound scan los ntsuas qhov mob hnyav (TTTS), uas yog, theem uas nws nyob hauv. Qhov no cia tus kws kho mob pom tias tus mob nce mus li cas thiab pom zoo cov kev kho mob zoo tshaj plaws.

Muaj tsib theem ntawm TTTS:

• Theem 1: Cov kua amniotic nyob ib puag ncig tus menyuam pub mis muaj tsawg heev lossis tsis muaj kiag li. Feem ntau muaj cov kua amniotic ntau dhau nyob ib puag ncig tus menyuam txais.
• Theem 2: Tus menyuam pub lub zais zis tsis pom thaum kuaj ultrasound. Qhov no txhais tau tias tus menyuam pub tsis tso zis li qub lawm.
• Theem 3: Muaj kev tsis sib npaug ntawm cov ntshav ntws ntawm cov menyuam mos. Qhov no yuav cuam tshuam rau kev ua haujlwm ntawm lub plawv ntawm ib tug menyuam.
• Theem 4: Ib tug lossis ob tug menyuam mos qhia cov cim ntawm daim tawv nqaij lossis lub cev o.
• Theem 5: Ib tug lossis ob tug menyuam tau tuag lawm.

Nyob rau theem 1 (TTTS), kev soj ntsuam ib leeg xwb yuav txaus lawm. Txawm li cas los xij, yog tias qhov mob hnyav zuj zus, nws tuaj yeem tshwm sim sai heev. Tom qab theem 2 (TTTS), yog tias koj cev xeeb tub tsawg dua 26 lub lis piam, feem ntau pom zoo kom phais menyuam hauv plab .

Cov kev kho mob rau (TTTS) yog dab tsi?

Kev kho mob nyob ntawm seb koj cev xeeb tub ntev npaum li cas thiab koj nyob rau theem twg ntawm TTTS.

• Kev Soj Ntsuam thiab Kev Saib Xyuas: Koj tus kws kho mob yuav saib xyuas koj cev xeeb tub nrog kev kuaj ultrasound. Qhov no yog ib qho kev xaiv yog tias koj muaj theem 1 (TTTS) lossis yog tias muaj laj thawj vim li cas kev phais lossis lwm yam kev kho mob tsis tuaj yeem ua tau.
• Kev phais qhov chaw mos: Qhov no yog kev ua ib lub qhov me me rau hauv daim nyias nyias ntawm ob tug menyuam lub hnab amniotic. Qhov no tuaj yeem ua kom lub siab sib npaug hauv ob lub hnab amniotic. Qhov no tsis muaj kev pheej hmoo ntau, tab sis nws tsis kho qhov ua rau muaj TTTS.
• Kev rho menyuam tawm:Hauv txoj kev kho mob no, tus kws kho mob siv ib rab koob me me, khoob los tshem cov kua amniotic ntau dhau ntawm tus menyuam lub hnab. Koj tus kws kho mob yuav pom zoo kom ua qhov no thaum theem 1 (TTTS) lossis thaum muaj mob hnyav ntawm TTTS tom qab cev xeeb tub. Txoj kev kho mob no tsis kho qhov ua rau muaj TTTS, yog li ntawd yog tias cov kua amniotic nce ntxiv dua, nws yuav tsum tau ua ntau zaus.
• Kev siv tshuaj laser fetoscopic ablation: Cov txheej txheem no suav nrog kev muab lub koob yees duab me me (fetoscope) rau hauv lub tsev menyuam thiab siv lub teeb laser los kaw cov hlab ntsha ntawm qhov chaw ntawm lub placenta uas ua rau cov ntshav ntws tsis sib npaug ntawm cov menyuam mos. Lub hom phiaj ntawm cov txheej txheem no yog hloov cov ntshav ntws ntawm ib tus menyuam mus rau lwm tus, kom txhua tus menyuam muaj cov ntshav sib cais. Qhov no yog ib qho kev xaiv rau theem 2 lossis siab dua (TTTS) thiab cev xeeb tub ntawm 16 thiab 26 lub lis piam.
• Kev phais mob txoj hlab ntaws: Qhov no yog ib txoj kev phais kawg uas koj tus kws kho mob yuav pom zoo thaum ob tug menyuam tsis tuaj yeem cawm tau, lossis thaum ib tug menyuam muaj mob hnyav heev. Kev phais no yuav ua rau cov ntshav ntws mus rau ib tug menyuam tsis txhob ntws, ua rau lwm tus menyuam muaj lub sijhawm zoo tshaj plaws los ciaj sia.
• Kev yug me nyuam: Yog tias tus me nyuam dhau lub hnub nyoog cev xeeb tub lawm, tus kws kho mob yuav pom zoo kom yug me nyuam.

Koj pab neeg saib xyuas kev noj qab haus huv yuav pab koj xaiv txoj kev kho mob uas zoo tshaj plaws rau koj. Lawv yuav teb tag nrho koj cov lus nug thiab nrog koj tham txog cov kev pheej hmoo, cov txiaj ntsig, thiab lwm txoj hauv kev ntawm txhua txoj kev kho mob.

Kev tswj hwm TTTS li cas?

Koj tus kws kho mob, nrog rau tus kws kho mob tshwj xeeb rau niam thiab menyuam hauv plab (MFM specialist), yuav saib xyuas koj cev xeeb tub ze ze. Koj yuav muaj kev kuaj ultrasound tsis tu ncua (tej zaum ib lossis ob zaug hauv ib lub lim tiam), thiab koj kuj tseem yuav tsum tau muaj fetal echocardiogram thaum koj cev xeeb tub. Koj pab neeg saib xyuas yuav muab kev txhawb nqa kev kho mob thiab kev xav rau koj thoob plaws koj cev xeeb tub.

Yog tias qhov no yog qhov teeb meem no, kuv yuav tsum cia siab li cas?

Qhov tshwm sim nyob ntawm seb koj cev xeeb tub ntev npaum li cas thaum kuaj pom tias koj muaj mob thiab qhov mob hnyav npaum li cas (theem). Nrog kev nce qib hauv kev kho mob, kev saib xyuas ze thiab kev kho mob thaum ntxov tuaj yeem ua rau ob tus menyuam muaj feem ntau dua los ciaj sia. Tham nrog koj tus kws kho mob txog kev cia siab thiab qhov tshwm sim uas yuav tshwm sim kom nkag siab tias TTTS yuav cuam tshuam li cas rau koj cev xeeb tub thiab koj tus menyuam. Ntau tus menyuam ntxaib uas tseem muaj sia nyob yuav tsum nyob hauv NICU (Neonatal Intensive Care Unit) ib ntus tom qab yug los kom pib tau raws li lawv xav tau.

(TTTS) tuaj yeem yog ib qho kev paub uas ua rau koj mob siab thiab ntxhov siab heev. Nco ntsoov saib xyuas koj tus kheej thiab nrhiav kev txhawb nqa los ntawm koj pab neeg kho mob, tus khub, thiab cov phooj ywg.

Tus nqi ciaj sia nyob hauv (TTTS) yog dab tsi?

Feem pua ​​ntawm cov neeg uas yuav muaj sia nyob yog nyob ntawm seb tus kab mob TTTS hnyav npaum li cas, thaum twg koj kuaj pom tias muaj tus kab mob no, thiab seb koj puas tau txais kev kho mob. Kev tau txais kev kho mob zoo tuaj yeem ua rau koj tus nqi ntawm cov neeg uas yuav muaj sia nyob nrog tus kab mob TTTS muaj qhov sib txawv loj heev:

• Kwv yees li ntawm 90% ntawm cov menyuam ntxaib uas kuaj pom tias muaj TTTS hnyav thaum ntxov cev xeeb tub muaj feem yuav tuag ua ntej yug los (yog tias tsis kho).
• Nruab nrab ntawm 85% thiab 90% ntawm cov cev xeeb tub uas tau kho (TTTS) ua rau muaj tsawg kawg ib tus menyuam uas tseem muaj sia nyob.
• Nruab nrab ntawm 50% thiab 65% ntawm cov cev xeeb tub uas tau kho (TTTS), ob tus menyuam yaus muaj sia nyob.

Vim muaj ntau yam uas cuam tshuam rau kev ciaj sia, tham nrog koj pab neeg saib xyuas koj tus menyuam txog qhov kev kwv yees ntawm nws lub neej.

Kuv yuav tsum nug kuv pab neeg kho mob li cas?

Qee cov lus nug koj tuaj yeem nug:

• Kuv cev xeeb tub txawv li cas ntawm kuv tus menyuam ntxaib uas tsis muaj (TTTS)?
• Kuv puas yuav tsum tau mus ntsib ib tus kws kho mob tshwj xeeb? Leej twg yog tus nyob hauv kuv pab neeg saib xyuas?
• Kuv yuav tsum tau kuaj mob lossis lwm yam kev kuaj mob ntau npaum li cas?
• (TTTS) yuav cuam tshuam li cas rau kuv cov phiaj xwm xa khoom?
• Puas yog kuv yuav hnov ​​​​​​muaj kev hloov pauv hauv kuv lub cev vim yog TTTS? Yog tias muaj, kuv yuav tsum xav li cas?
• Koj xav kom kuv kho kuv tus mob li cas? Vim li cas?
• Koj pom zoo kom ua neej li cas (xws li kev noj zaub mov, kev tawm dag zog, kev so, kev kho mob) los txhawb kuv txoj kev noj qab haus huv?

Qhov 'Daisy Baby' no yog dab tsi?

'Daisy baby' yog lwm lub npe rau tus menyuam uas muaj TTTS. Lub Koom Haum Twin-to-Twin Transfusion Syndrome (TTTS) tau siv lub npe no thawj zaug. Lub npe no tau tshwm sim tom qab tus tsim nws tau cog cov noob daisy hauv lawv lub vaj nrog nws cov tub ntxaib uas tseem muaj sia nyob. Lub vaj daisy yog lub cim ntawm kev cia siab tias txhua tus menyuam uas muaj TTTS yuav muaj sia nyob.

Thaum kawg, qhov tseem ceeb tshaj plaws! (Cov Lus Coj Mus Tsev)

Kev kuaj pom tias muaj Twin-to-Twin Transfusion Syndrome (TTTS) tuaj yeem yog ib qho kev paub txaus ntshai. Nws yog ib qho ib txwm muaj uas yuav ntshai thiab ntxhov siab txog yam tom ntej rau koj thiab koj cov menyuam ntxaib. Tham nrog koj tus kws kho mob txog cov kev kho mob zoo tshaj plaws rau koj qhov teeb meem. Nrhiav kev txhawb nqa los ntawm cov phooj ywg thiab tsev neeg thaum koj cev xeeb tub mus ntxiv. Kev koom nrog ib pawg neeg txhawb nqa rau cov tsev neeg uas tau muaj TTTS kuj tseem tuaj yeem yog ib txoj hauv kev zoo los pab koj hla txoj kev no. Nco ntsoov, koj tsis nyob ib leeg. Nrog cov lus qhia thiab kev txhawb nqa kho mob zoo, koj yuav muaj peev xwm ntsib qhov teeb meem no!

` Kab Mob Hloov Ntshav Rau Ob Tug Me Nyuam, TTTS, menyuam ntxaib, cev xeeb tub, placenta, kua amniotic, monochorionic