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绒癌和侵蚀性葡萄胎患者化疗后一年内妊娠结局的分析 |
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朱兰 杨秀玉 宋鸿钊 向阳
【摘要】 目的 探讨绒癌和侵蚀性葡萄胎患者多疗程化学治疗（化疗）后，1年内妊娠的结局。方法 分析绒癌和侵蚀性葡萄胎患者化疗后在1年内妊娠的22例发生异常妊娠、废胎率的情况及其与化疗停药的间隔的关系。结果 22例中,足月分娩9例,废胎6例,废胎率为27.3% 。其中停止化疗半年内妊娠者废胎率高于半年以上者(P<0.05)。患者发生产后绒癌1例，发生重复性葡萄胎1例，此2例均发生在停药5个月内妊娠。结论 绒癌和侵蚀性葡萄胎经化疗保留子宫是可行的。但多疗程化疗后,妊娠不宜太早,应至少避孕半年,最好避孕1年。
【关键词】 滋养层肿瘤 药物疗法 妊娠结局
Pregnancy of Patients Conceived within One Year after Chemotherapy for Gestational Trophoblastic Tumor
ZHU Lan, YANG Xiuyu, SONG Hongzhao, et al.
Peking Union Medical College,Beijing 100730
【Abstract】 Objective To explore the risk of pregnancy in patients conceived within one year after successful chemotherapy for gestational trophoblastic tumor. Methods 22 patients conceived within one year after chemotherapy were followed up and analysed about abnormal pregnant result, wastage rate and the time of interval between chemotherapy and pregnancy. Results Among 22 cases,9 cases were full term birth,6 cases were wastage. The wastage rate was 27.3%. The wastage rate of these patients conceived within half a year was higher than one year (P<0.05).1 repeated hydatidiform mole and one post term choriocarcinoma occurred in 22 patients. They both were conceived within 5 months after chemotherapy. Conclusions Preservation of fertility is feasible in patients suffering from choriocarcimona and invasive mole. But these patients should practise contraception at least half a year after chemotherapy, and it s better to advise patients to take contraception for one year.
【Key words】 Trophoblastic neoplasms Drug therapy Pregnancy outcome
妊娠滋养细胞肿瘤患者经大剂量化学治疗(化疗)，不但绝大部分可获得根治,还有可能保留生育功能。化疗治愈的患者一般要求严格避孕1年以上,但少数患者在1年内妊娠,这类患者的妊娠结局究竟如何,国内外尚未见报道。现将我院于1966～1996年诊治的22例的情况报道如下。
资料与分析
1966年至1996年,我院治愈的恶性滋养细胞肿瘤,随诊中1年内妊娠的患者共22例，年龄23～32岁,平均25.6岁。22例中，4例曾有分娩史（其中1例无成活孩子）。
一、诊断与临床期别
绒癌和侵蚀性葡萄胎的诊断标准及临床分期，均按我院既往的方法［1］。22例中,绒癌11例,源于产后2例,自然流产后2例,人工流产后5例,葡萄胎后2例。绒癌1[1] [2] 下一页
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