妊娠滋养细胞肿瘤手术治疗的价值及相关因素探索  

The value of surgical intervention in the treatment of gestational trophoblastic neoplasia and its related factors

作　　者：方堃[1] 覃庆锋[1] 邱芳[1] 邓丹妮 丁娅妮 满琳 FANG Kun;QIN Qingfeng;QIU Fang;DENG Danni;DING Yani;MAN Lin(Department of Gynecology,Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院妇科,贵州贵阳550002

出　　处：《中国现代医生》2023年第33期23-25,61,共4页China Modern Doctor

基　　金：贵州省科技计划项目(黔科合支撑[2021]一般040)。

摘　　要：目的妊娠滋养细胞肿瘤(gestational trophoblastic neoplasia,GTN)治疗方法主要为化疗,部分患者需手术干预。本研究旨在评估手术在GTN患者治疗中的作用及探讨手术治疗效果的影响因素。方法回顾性分析2010年6月至2020年6月于贵州省人民医院就诊的11例GTN患者的资料。接受子宫切除术、子宫病灶切除术、肺部病灶切除术、开颅病灶清除术、阴道壁病灶清除术等外科手术的患者均纳入本研究。结果11例患者的生存率为100%。患者平均年龄34.64岁。子宫切除术2例(18.18%),子宫病灶切除术2例(18.18%),肺病灶切除术3例(27.27%),开颅病灶清除术2例(18.18%),阴道壁病灶清除术1例(9.1%),宫颈病灶清除术1例(9.1%)。11例患者全部治愈。对手术的反应与术前β-HCG值、术前化疗次数等关系显著。结论手术在GTN患者的治疗中具有重要作用,术前β-HCG和围手术期化疗周期影响治疗的应答率。Objective Chemotherapy is main therapy for gestational trophoblastic neoplasia(GTN),but some patients still need surgical intervention.This study aimed to evaluate the role of surgery in the treatment of GTN patients,and explore the influencing factors of surgical treatment.Medthods A total of 11 GTN patients were collected in Guizhou Provincial People’s Hospital from June 2010 to June 2020.Patients underwent hysterectomy,excision of uterine lesions,pneumonectomy,craniotomy,vaginal wall debridement and other surgical operations.Results The survival rate of 11 patients was 100%.The average age of patients was 34.64 years old.Hysterectomy in 2 cases(18.18%),uterine lesions excision in 2 cases(18.18%),pneumonectomy in 3 cases(27.27%),craniotomy in 2 cases(18.18%),vaginal wall in 1 case(9.1%),and cervical lesion in 1 case(9.1%).All 11 patients were cured.The relationship between surgical effect and preoperativeβ-HCG value,preoperative chemotherapy times is significant.Conclusion Operation plays an important role in the treatment of GTN patients.Preoperativeβ-HCG and perioperative chemotherapy cycle affect the response rate of treatment.

关 键 词：妊娠滋养细胞肿瘤 耐药性 出血 外科手术 

分 类 号：R711[医药卫生—妇产科学]