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目的:探讨子宫切除术对恶性滋养细胞肿瘤的治疗效果、手术时机及手术的必要性。方法:对濮阳市油田总医院1998年1月～2008年6月收治的46例恶性滋养细胞肿瘤的临床资料进行回顾性分析。其中26例因无生育要求及耐药行子宫切除术,20例单纯行化疗。结果:20例单纯化疗中患者全部治愈。26例子宫切除患者中23例均治愈,随访2～10年均无复发,1例因骨髓Ⅳ度抑制不能化疗死于脑转移;3例耐药患者行子宫切除后继续化疗治愈出院,1例再次耐药,转至上级医院;1例预后评12分高危绒癌患者治疗出院半年后复发,化疗耐药死亡。结论:恶性滋养细胞肿瘤治疗以化疗为主,很多患者可以行单纯化疗而不行任何手术。但在某些急诊出血、高危耐药病例,手术治疗有一定价值。
Objective: To investigate the effect of hysterectomy on malignant trophoblastic tumor, the timing of surgery and the necessity of surgery. Methods: The clinical data of 46 cases of malignant trophoblastic tumor treated in Puyang Oilfield General Hospital from January 1998 to June 2008 were retrospectively analyzed. Twenty-six cases were treated with simple chemotherapy due to the requirement of having no fertility and resistant hysterectomy. Results: All patients were cured in 20 cases of simple chemotherapy. Twenty-six cases of hysterectomy were cured, 23 cases were followed up for 2 to 10 years without recurrence, 1 case died of brain metastasis due to bone marrow Ⅳ degree of chemotherapy can not chemotherapy; 3 cases of resistant patients were cured after hysterectomy and cured, 1 case Once again resistant, go to the higher hospital; 1 case of prognosis, 12 points high-risk choriocarcinoma patients discharged after six months of recurrent chemotherapy death. Conclusion: Chemotherapy is the main treatment for malignant trophoblastic tumor. Many patients can undergo chemotherapy without any surgery. However, in some emergency bleeding, high-risk drug-resistant cases, surgical treatment has some value.