47例高危型妊娠滋养细胞肿瘤的临床资料分析

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1、授予单位代码10089学号或申请号20123206对妗(E科HHebeiMedicalUniversity硕士学位论文专业学位47例高危型妊娠滋养细胞肿瘤的临床资料分析研究生：赵晓梅导师：冯华教授专业：妇产科学二级学院：第四医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公幵和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科

2、大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。研究生签名导师签章：二级学院领导盖章河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人己经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：导师签章：*y(年3取曰目录中文摘要··························································

3、···················1英文摘要·············································································3英文缩写·············································································6研究论文47例高危型妊娠滋养细胞肿瘤的临床资料分析前言··············································

4、·······························7材料与方法····································································7结果·············································································10附表····································································

5、·········20讨论·············································································29结论·············································································33参考文献·······································································34综述妊娠滋养细

6、胞肿瘤的诊断和治疗······································38致谢···················································································46个人简历·············································································47中文摘要47例高危型妊娠滋养细胞肿瘤的临床资料分析摘要目的：妊娠滋养细胞肿瘤

7、（GTN）是一种发生于年轻育龄期妇女的可治愈性的肿瘤。化学治疗是妊娠滋养细胞肿瘤的主要治疗方法。应本着个体化、分层的原则对不同的患者制定不同的化疗方案。高危型妊娠滋养细胞肿瘤应给予联合化疗方案治疗，我院首选EMA/CO方案。本文对应用两种不同化疗方案治疗的47例高危型妊娠滋养细胞肿瘤的临床效果及毒副反应情况进行对比和评价，旨在为该病的临床治疗积累经验。方法：回顾性分析2004年12月-2013年12月河北医科大学第四医院妇科收治的有完整病例资料的初治的高危型妊娠期滋养细胞肿瘤的患者47例，应用EMA/CO化疗

8、方案治疗的23例患者归为对照组，应用EMA/CO＋EMA化疗方案治疗的24例患者归为研究组：该组患者开始进行化学治疗的平均一个或二个疗程为EMA/CO化疗方案，但因其出现严重的化疗毒副反应（Ⅰ级及以上）并且血清β-HCG呈对数下降，后续的化疗疗程均改为EMA化疗方案。根据妊娠滋养细胞肿瘤化疗之后的疗效评价标准，在化疗的第6程末分别评价两组病患的治疗的有效率；根据WHO抗癌药物毒性反应的分级标准分别进