预防性子宫切除对40岁以上葡萄胎患者恶变为妊娠滋养细胞肿瘤的治疗效果探讨  

Therapeutic Function of Prophylactic Hysterectomy in Patients at Least 40 Years Old with Gestational Trophoblastic Tumor

作　　者：朱烨[1] 李娟[1] 雷月[1] 张妍[1] 苏亦平[1] ZHU Ye;LI Juan;LEI Yue(Woman′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Nanjing Jiangsu 210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)妇科,江苏南京210004

出　　处：《实用妇产科杂志》2022年第6期450-453,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:评估预防性子宫切除对40岁以上葡萄胎患者恶变为妊娠滋养细胞肿瘤(GTN)的治疗效果。方法:回顾性分析南京医科大学附属妇产医院2012年1月至2020年5月期间收治40岁以上葡萄胎患者共78例,其中预防性子宫切除患者40例、期待治疗患者38例,对相关临床资料进行分析。结果:预防性子宫切除组葡萄胎恶变率(37.5%)与期待治疗组(50.0%)比较,差异无统计学意义(P>0.05);恶变组的平均停经时间(10.92±3.65周)较治愈组(8.36±4.35周)长,差异有统计学意义(P<0.05);期待治疗后GTN化疗前血β-hCG数值、化疗疗程及耐药率较预防性子宫切除后GTN高,差异有统计学意义(P<0.05)。结论:对于40岁以上的葡萄胎患者,预防性子宫切除可以提高GTN的早期诊断率,降低化疗量,且无增加转移病灶的风险,可以作为有效的治疗策略。Objective:The purpose of this study was to evaluate the therapeutic effectiveness of prophylactic hysterectomy on malignant transformation to gestational trophoblastic neoplasm(GTN)in patients at least 40 years of age with the hydatidiform mole.Methods:A total of 78 patients at least 40 years old with hydatidiform mole admitted Woman′s Hospital of Nanjing Medical University between January 2012 and May 2020,including 40 patients with prophylactic hysterectomy and 38 patients with expectant treatment,were retrospectively analyzed for relevant clinical data.Results:The canceration rate of hydatidiform mole in the prophylactic hysterectomy group(37.5%)was not significantly different from that in the expectant treatment group(50.0%),P>0.05.The mean duration of amenorrhea was longer in the GTN group(10.92±3.25 weeks)than in the cured group(8.36±4.35 weeks),and the difference was statistically significant(P<0.05);Pre-chemotherapy serumβ-hCG values,duration of chemotherapy,and drug resistance rates were higher in the expectant treatment group than in prophylactic hysterectomy group,with statistically significant differences(P<0.05).Conclusions:For patients at least 40 years old with hydatidiform mole,prophylactic hysterectomy can be an effective treatment strategy by improving the early diagnosis of GTN,reducing the amount of chemotherapy,and without increasing the risk of metastatic lesions.

关 键 词：妊娠滋养细胞肿瘤 葡萄胎 子宫切除术 治疗 

分 类 号：R737.33[医药卫生—肿瘤]