分析葡萄胎恶变的临床特点，研究其预防性化疗的效果及指征

《分析葡萄胎恶变的临床特点，研究其预防性化疗的效果及指征》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、中文摘要目的分析葡萄胎恶变的临床特点，研宄其预防性化疗的效果及指征。方法回顾性分析235例葡萄胎患者临床资料，通过分析化疗组高危葡萄胎患者的临床特点，探讨其预防性化疗指征，并比较氟尿嘧啶和甲氨蝶呤两种化疗方案奋效性及毒副作用。结果1、合并各种高危因素的葡萄胎患者组恶变率显著高于未合并高危因素组，P<0.05。2、有高危因素的葡萄胎患者出现恶变与先期妊娠的吋间间隔显著短于无高危因素组，P<0.05。3、化疗组恶变率为5.4%;未化疗组恶变率为18.4%;低危组恶变率为8.2%;恶变率之间有统计学意义，说明预防性化疗能降低葡萄胎的恶变率。

2、4、化疗组屮对38例采用氟尿嘧啶化疗，18例采用甲氨蝶呤化疗，比较两组血HCG转阴所需化疗疗程无统计学意义，说明两种化疗方案有效性相似；5、在毒副作用方面，甲氨蝶呤方案中腹泻和口腔溃疡的发生率均低于氟尿嘧啶方案，在恶心呕吐、肝损害及骨髓抑制方面无明显差异，且两种化疗副作用对于大部分病人的耐受性良好。结论在预防葡萄胎患者恶变方面预防性化疗有一定的砬用价值，尤其合并高危因素的葡萄胎患者，高危葡萄胎患者行预防性化疗的方案中甲氨蝶呤优于氟尿嘧啶。【关键词】妊娠滋养细胞疾病；葡胎；妊娠滋养细胞肿瘤；恶变;预防性化疗；氟尿嘧啶；甲氨蝶呤Abstr

3、actObjectiveToanalyzetheclinicalcharacteristicsofmalignantmoleandinvestigateitseffectofpreventivechemotherapyandindications.MethodsTheclinicalfeaturesof235patientswithhydatidiformmolewereretrospectivelyanalyzed.Thoughanalyzingtheclinicalcharacteristicsofthepatientsinthe

4、chemotherapygroup，wecanevaluateitsindicationsandsignificance.Andthesideeffectsandefficacyofchemotherapybetweenthefluorouracilandmethotrexatewerecompared.Results1.Themalignantratioofmolepatientswithhighriskfactorswassignificantlyhigherthanpatientswithouthighriskfactors.2

5、.ThepatientswithandwithouthighriskfactorshadsignificantlydifferencesintheintervalbetweenearlypregnancyandpostmolarGTN.3.Thehigh-riskgroupwithchemotherapy，thehigh-riskgroupwithoutchemotherapyandthelow-riskgroupwerestatisticallysignificantdifferencesinmalignanttransformat

6、ionrate.4.Requiringcoursesofchemotherapygroupbetweenthefluorouracilandmethotrexategroupwasnosignificantdifference.5.Methotrexateinincidenceofdiarrheaandmouthulcerswerelowerthanfluorouracil.Buttheywasnosignificantdifferenceinthenausea,vomiting，bonemarrowsuppressionandliv

7、erdysfunction.ConclusionsPreventivechemotherapyinpreventinggestationaltrophoblastichavesomeclinicalvalue,especiallyforhighriskofmalignancyinpatientswithhydatidiformmole.Thepreventivechemotherapyofmethotrexateinthehigh-riskgestationalissuperiortofluorouracil.KeywordsGest

8、ationaltrophoblasticdisease;Hydatidiformmole;Gestationaltrophoblasticneoplasia;Malignant;Preventivechemotherap