子宫切除术在妊娠滋养细胞肿瘤治疗中的应用

目的探讨子宫切除术在妊娠滋养细胞肿瘤治疗中的应用.方法对本院1985年1月～2003年12月,因妊娠滋养细胞肿瘤而行子宫切除术的61例病例进行回顾性分析.结果年龄较大无生育要求患者术前经短暂化疗后择期行全子宫切除术,均获完全缓解;因子宫穿孔或子宫大出血而急诊的患者进行全子宫切除术,其中1例死于大出血;因产生化疗耐药,且考虑病灶主要局限于子宫的患者施行子宫切除辅助化疗;无生育要求者为缩短化疗疗程,行选择性子宫切除.结论应严格把握手术指征,根据年龄、疾病类型及是否为高危患者选择适当的手术方式.

The application of surgical treatment in gestational trophoblastic tumor

Objective To discuss the application of hysterectomy for gestational trophoblastic tumor patient.Methods Total of 61 cases of gestational trophoblastic neoplasm treated by hysterectomy during the period between January,1985 to December,2003 at the First Hospital of Xi'an Jiaotong University was retrospectively analyzed.Results We have selected 14 cases of elder patients without desire to preserve fertility to perform hysterectomy after several short period courses of chemotherapy,who all been completely cured finally.The emergency hysterectomy was performed for 8 patients with uterine perforation or life-threatening hemorrhage,of whom,one patient dead of hemorrhage;20 chemo-refractory cases who were suspected with an isolated lesion in the uterus had delayed hysterectomy as an adjunct managment of chemotherapy;19 patients without desire to preserve fertility were selected for hysterectomy so as to shorten the courses of chemotherapy. Conclusion For certain patients,operation remains an important adjunct management of the gestational trophablastic tumor.