卵胞质内单精子注射术后双胎之一完全性葡萄胎伴肺转移活产1例  

Complete hydatidiform mole and coexisting fetus with pulmonary metastases after intracytoplasmic sperm injection:a case report

作　　者：宋婷 贾红靖 周婷 黄强 梁宝权[1] SONG Ting;JIA Hongjing;ZHOU Ting;HUANG Qiang;LIANG Baoquan(Department of Gynecology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215000,Jiangsu,China;Ultrasound Center,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215000,Jiangsu,China;Department of Gynecology,the Fourth Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]南京医科大学附属苏州医院妇科,江苏苏州215000 [2]南京医科大学附属苏州医院超声中心,江苏苏州215000 [3]苏州大学附属第四医院妇科,江苏苏州215000

出　　处：《中国性科学》2025年第2期55-61,共7页Chinese Journal of Human Sexuality

基　　金：苏州市2021年度科技发展计划项目(SKY2021056);2023年苏州姑苏卫生青年拔尖人才项目(GSWS2023059)。

摘　　要：随着诱导排卵和辅助生殖技术的广泛应用,妊娠合并完全性葡萄胎(CHMCF)的发病率呈显著上升趋势。本文回顾性分析南京医科大学附属苏州医院收治的1例接受供卵行卵胞质内单精子注射(ICSI)术后发生双胎之一完全性葡萄胎伴肺转移的患者最终成功获得活产的诊疗过程。该患者在孕早期经超声检查提示双绒双胎,其中一胎为完全性葡萄胎,孕中期行胸部CT检查发现多发肺部结节。最终,患者经剖宫产于孕34周获得活产,术后病理检查确诊为CHMCF。产后随访3年,患者无明显不适症状,血清人绒毛膜促性腺激素(hCG)水平下降满意且肺部结节自行缩小或消失,未接受放化疗治疗。对于CHMCF伴肺转移的患者,及时诊断与个体化治疗是提高活产率和减少母婴并发症的关键。未来仍需进一步探讨CHMCF的发病机制,并积极优化治疗方案,改善患者预后。With the wide application of ovulation induction and assisted reproductive techniques,the incidence rate of complete hydatidiform mole and coexisting fetus(CHMCF)showed a significant upward trend.This paper retrospectively analyzed the diagnostic and therapeutic process of a case of complete hydatidiform mole with pulmonary metastasis following oocyte donation and intracytoplasmic sperm injection(ICSI)at the Affiliated Suzhou Hospital of Nanjing Medical University,who ultimately achieved a live birth.The ultrasonography examination of patient in the first trimester suggested a dichorionic diamniotic twin pregnancy,with one fetus being a complete hydatidiform mole.Multiple pulmonary nodules were detected by chest CT in the second trimester.The patient delivered a live birth via cesarean section at 34 weeks of gestation,and the pathological examination postpartum confirmed CHMCF.During the 3-year follow-up after delivery,the patient exhibited no significant discomfort.The serum human chorionic gonadotropin(hCG)levels decreased satisfactorily,and the pulmonary nodules shrank or disappeared spontaneously without the need for radiotherapy or chemotherapy.The findings of this study indicate that timely diagnosis and individualized treatment are crucial for improving the live birth rate and reducing maternal and neonatal complications in patients with CHMCF with pulmonary metastasis.Further exploration of the pathogenesis of CHMCF and active optimization of treatment protocols are still needed in the future to improve patient outcomes.

关 键 词：双胎妊娠 完全性葡萄胎 共存活胎 肺转移 

分 类 号：R714[医药卫生—妇产科学]