滋养叶细胞肿瘤的介入治疗

目的 探讨滋养叶细胞肿瘤的介入治疗价值及临床意义。方法 2005-11～2006-11，我科共介入治疗滋养叶细胞肿瘤22例，其中恶性葡萄胎18例，绒毛膜细胞癌4例。年龄25～68岁，平均年龄32．5岁。以介入技术的经导管肿瘤供血动脉灌注或经导管肿瘤供血动脉栓塞术，以Seldinger穿刺技术穿刺单侧股动脉成功后置入4～5F血管鞘后，引入4～5F特选导管行肿瘤供血血管超选择，超选成功后造影证实肿瘤染色后，视肿瘤染色情况行肿瘤供血动脉灌注化疗，恶性葡萄胎病人化疗药物以5-Fu（单次用量不超过1．0g）为主，绒毛膜细胞癌病人以5-Fu＋甲氨蝶呤（单次用量5-Fu不超过1．0g，MTX不超过100mg）。需要行经肿瘤供血血管栓塞的病人以超液态碘化油（5．0～10mL）＋表阿霉素（40mg）＋5-Fu（1．0g）＋顺铂（100mg）（或MTX50mg）乳化。结果 22例病人以介入经导管动脉灌注化疗1次性治愈的15例（恶性葡萄胎12例，绒毛膜细胞癌3例），其余7例行2次灌注好转治愈的5例，2例行子宫动脉灌注化疗及栓塞术后好转。结论 滋养叶细胞肿瘤的介入治疗疗效确切，见效快．创伤小。具有临床应用及推广价值。

Interventional Treatment of Trophocyte Tumor

Objective To discuss the value and clinical significance of trophocyte tumor with interventional treatment.Methods22 cases of such patient from November 2005 to November 2006 with average age of 32.5 years(25～68) were underwent interventional treatment.Among them,there were 18 cases of malignant hydatidiform mole,4 cases of chorion carcinoma.5 FU and MXT were used for chemotherapy.If the blood vessel emboization was taken 5Fu,DDP,or MTX were used.Results15 of 22 cases were healed with first catheter perfusion other 7 cases were healed with twice perfusion and 2 cases recovered.ConclusionThis method might have good and rapid effect with less injury.So it should be wildly used in clinic.