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目的分析耐药性妊娠滋养细胞肿瘤的治疗特点,提高对疾病的认识,探讨有效的治疗方案,提高治愈率。方法选取右江民族医学院附属医院2010-01-2015-12接诊的妊娠滋养细胞肿瘤患者60例,对所有患者的临床资料进行回顾性分析。结果 20例患者出现耐药,其中绒癌4例,其中有1例肺转移,侵蚀性葡萄胎16例,其中有5例肺转移。低危患者4例,高危患者16例。单药耐药患者15例,多药耐药患者5例。所有患者均以化疗为主要治疗方式,单纯化疗12例,治疗有效率100%,联合手术治疗8例,有效率100%。结论复发性耐药性妊娠滋养细胞肿瘤的治疗手段应以化疗为主,根据患者的实际情况制定个性化的化疗方案,对于子宫和其他部位有持续性病灶的患者,在化疗的基础上联合子宫手术或转移其他部位的孤立性耐药病灶切除术,提高治愈率,改善患者的预后。
Objective To analyze the therapeutic features of drug-resistant gestational trophoblastic tumor, to improve the understanding of the disease, to explore effective treatment options and to improve the cure rate. Methods 60 cases of gestational trophoblastic tumor admitted to Youjiang Medical College Hospital from January 2010 to December 2015 were enrolled in this study. The clinical data of all patients were analyzed retrospectively. Results Twenty patients developed resistance, of which 4 were choriocarcinoma, of which 1 had lung metastasis, 16 had invasive hydatidiform mole, and 5 had pulmonary metastasis. 4 cases of low-risk patients, high-risk patients in 16 cases. Fifteen patients were single drug resistance and five patients were multidrug resistance. All patients with chemotherapy as the main treatment, chemotherapy alone in 12 cases, the effective rate of 100%, combined with surgical treatment of 8 cases, the effective rate of 100%. Conclusion The treatment of recurrent drug-resistant gestational trophoblastic tumor should be based on chemotherapy, according to the actual situation of patients to develop personalized chemotherapy regimens for uterine and other patients with persistent lesions in patients with chemotherapy based on the joint uterus Surgery or other parts of the isolation of resistant lesions removal surgery to improve the cure rate and improve the prognosis of patients.