Clinical Analysis Of 103 Cases Of Gestational Trophoblastic Disease

Objective Through retrospective analysis of 103 cases of gestational trophoblastic disease,we summarized the possible influencing factors,clinical features,treatment methods of gestational trophoblastic disease,influencing factors of malignant transformation of hydatidiform mole and improved clinical diagnosis and treatment thinking.Research methods A total of 103 patients with gestational trophoblastic disease from January 2016 to December 2018 in our hospital were enrolled,including 71 cases of hydatidiform mole,32 cases of gestational trophoblastic tumor,and including 21 cases of invasive mole frome 32 cases of GTN.11 cases of choriocarcinoma from 32 cases of GTN,retrospective analysis.Results(1)90.29%(93/103)of patients with GTD have a higher incidence rate at < 40 years of age,among which the proportion of hydatidiform moles in patients <40 years old is as high as 70.97%,and the proportion of GTN patients in< 40 years old is as high as 29.03%(27/93),and the age is ?40 years old.The GTD has a malignant composition is up to50%(5/10).(2)In 103 cases of GTD,benign GTD and malignant GTD were compared.X2 analysis showed that HCG,menopause,nausea and vomiting,and ovarian luteinized cyst were statistically significant(P<0.05).(3)Among the 32 patients with GTN,single-drug chemotherapy and multi-drug combination chemotherapy were compared.The chi-square analysis showed that there were significant differences in FIGO stage,FIGO prognosis score and GTN type(P<0.05).GTN The comparison between the types found that the poor pregnancy history and FIGO prognosis scores were statistically significant(P<0.05).The overall incidence of adverse reactions according to the size of chemotherapy were leukopenia(75%)and nausea and vomiting(50%),abdominal pain and diarrhea(46.88%),the percentage of adverse reactions caused by single-drug chemotherapy and multi-drug combination chemotherapy were different.The incidence of adverse reactions of single-drug chemotherapy was leukopenia(77.27%),nausea and vomiting(40.91%),abdominal pain and diarrhea(54.55%);and the incidence of common adverse reactions of multi-drug combination chemotherapy is leukopenia(70%),nausea and vomiting(70%),myelosuppression(50%);effective rate of single drug chemotherapy For 100%(11/11),the effective rate of multi-drug chemotherapy was 80%(8/10),and the overall cure rate was as high as 93.75%.Compared with the two treatment measures,P>0.05,the difference was not statistically significant.4)There were statistically significant differences between malignant changes of hydatidiform mole and ovarian luteinized cyst,number of uterine clearings,and blood HCG onadmission(P<0.05).Conclusions(1)The incidence of GTD is mostly women of childbearing age,and women with age ? 40 years have a higher composition of GTN.(2)those with benign GTD are more likely to be admitted to hospital blood HCG(?104miu/ml),clinical manifestations of menopause,vomiting in pregnancy,ovarian luteinized cysts.(3)FIGOIII stage--IV stage and FIGO prognosis score are extremely high risk.When GTN is choriocarcinoma,it is easier to choose multi-drug combination chemotherapy.Have a history of adverse pregnancy and the FIGO prognosis score is high risk more common in choriocarcinoma.(4)Both chemotherapy regimens are prone to leukopenia and nausea and vomiting,but bone marrow suppression is more likely to occur in multidrug combination chemotherapy,and both treatment regimens are more effective.(5)ovarian luteinized cysts,hospital admission blood HCG ? 104 miu / ml,the number of times ? 2 times are more likely to occur malignant transformation of hydatidiform mole.