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目的 探讨手术在滋养细胞肿瘤治疗中的作用及其决定因素。方法 回顾分析 1991年 1月至2 0 0 3年 1月间我院住院滋养细胞肿瘤 6 0例 ,分为手术组 (32例 )和非手术组 (2 8例 ) ,比较两组相关高危因素 ,并对手术指征进行分析。结果 手术组有较高的高危评分 (7 2 ) ,手术组年龄超过 4 0岁、末次妊娠为足月、绒癌比例、末次妊娠至诊断时间超过 2年均明显高于非手术组 (P <0 0 5 )。手术指征为 :子宫穿孔或阴道大出血、卵巢囊肿蒂扭转 ;耐药或复发、胎盘部位滋养细胞肿瘤、年龄超过 4 0岁或无生育要求。结论 手术在控制出血、耐药复发病例、胎盘部位滋养细胞肿瘤起主要作用 ,而对一般病例也有提高疗效 ,缩短疗程等积极作用。高危因素可以作为决定手术的一项参考指标。
Objective To investigate the role of surgery in trophoblastic tumor therapy and its determinants. Methods A retrospective analysis of 60 cases of inpatient trophoblastic tumor in our hospital from January 1991 to January 2003 was divided into operation group (32 cases) and non-operation group (28 cases). The relative risk factors , And analysis of surgical indications. Results The operation group had a higher risk score (72). The age of the operation group was over 40 years old. The rate of full-term and choriocarcinoma in the last pregnancy was significantly higher than that of the non-operation group (P < 0 0 5). Surgical indications: uterine perforation or vaginal bleeding, ovarian cyst torsion; drug resistance or relapse, placental trophoblastic tumor, more than 40 years of age or without childbearing requirements. Conclusion Surgery plays a major role in the control of hemorrhage, drug-resistant recurrence and placental trophoblastic tumor, and positive effects such as improving curative effect and shortening the course of treatment in general cases. Risk factors can be used as a guideline for determining surgery.