Analysis of 15 cases of pregnancy rare site _2743

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Analysis of 15 cases of pregnancy rare site

After treatment by the grape Yi and experience expressed as follows: 1 patient clinical data Example 1 female, 53 years old. Amenorrhea after 13 months because of intermittent vaginal bleeding and intermittent abdominal pain for 5 days on August 5, 1993 admission. Amenorrhea in patients in July 1992 after 13 months, no vaginal bleeding, fluid flow, and two will be normal appetite. Japan 1993 81 111 vaginal bleeding with intermittent abdominal pain, vaginal bleeding increased the next day, abdominal pain intensified. Local hospitals and B-ultrasound of uterine fibroids prompt invalid given oxytocin into the hospital bleeding. The patient had previous menstrual regularity, pregnancy 4 production 3. 19 years ago, the last physical examination in pregnancy: generally good, mild anemia and appearance, no abnormal cardiopulmonary examination, abdominal soft. Film f pi ribs no time, no abdominal tenderness and rebound tenderness. Gynecological examination: The middle-style vulva, vagina more blood, cervical mouth open, neck organized jam, Palace 13 weeks pregnant size, activities. Soft texture. Annex: delete no time lump. Laboratory tests, blood IIb85g / L, more than normal, urine normal, I even. Normal renal function. Hospitalization: the placenta and curettage see some blisters like organization, the pathological diagnosis of hydatidiform moles. To prevent malignant, August 13 rows hysterectomy, endometrial pathology and diagnosis of superficial slow muscle fit to live with inflammatory cell infiltration. Residues and no fluff Yi disk malignant lesions. Hysterectomy Yue HCG508g / L, with 5-fluorouracil to prevent a chemotherapy. Because of abdominal figurines, stool frequency increased in the first 9 days withdrawal, the blood that HCG has not returned to normal, respectively, in October 1993 28Et, 12 8, 7 March 1994, April 1, April 28 Application of methotrexate and 5 fluorouracil-opening one. The end of each chemotherapy, the patient appeared peeling hands and feet, abdominal pain, stool frequency increased, oral ulcers. Although serum HCG decreased 7.7g / L, several group of chest X-ray, B ultrasonic examination, gynecological examination, metastatic lesions were not found in repeated chemotherapy. Mild abnormal liver function. Financial resources for patients _1: foot. Automatically stop f {II died two months after treatment. Li 2, the patients were women. 54. Abdominal mass was found two more than a month, f-1996 年 5 day of admission. The patient was two years ago, amenorrhea and no bleeding until March before admission,[link widoczny dla zalogowanych], in April the two vaginal bleeding, half to a sense of nausea, vomiting, breast swelling sense of touch for two days of a mass in the lower abdomen and treatment. B-ultrasound Tip: trophoblastic disease. Previous menstrual regularity, pregnancy 7 production 2, pregnancy in the last 2O years ago. Physical examination: development of good nutrition. Normal cardiopulmonary auscultation. Gynecological examination: The middle-style vulva, cervix light Mi, 14 weeks pregnant Palace size. Spray in the activities. And the bilateral attachment end. Laboratory examination: urine routine, liver and kidney function was normal. Blood HCG> 8001U/mI, -HCG320MIU/ml. Curettage before admission line. See grape tissue 150g. Pathological diagnosis: hydatidiform moles. A week later a second curettage, pathological diagnosis: hemorrhagic necrosis. Endometrial epithelium was A-S reaction, no obvious trophoblastic components. Curettage surgery, continued to decline due to blood HcG, application of a 5-fluorouracil chemotherapy. After stopping abdominal pain, diarrhea, 71,126 applications methotrexate on purine treatment. At the same time with folinic CF detoxification, there is still blood rash, mouth ulcers. At 81,115 a day in total hysterectomy and bilateral attachment removal, ovarian vein ligation. Pathological diagnosis, aggressive hydatidiform moles. 12 days after application of actinomycin treatment to normal blood HCG, CT examination, no significant lesions in both lungs. Since heavy chemotherapy, the patient was discharged resolutely unwilling to consolidation therapy, follow-up has normal blood HCG. 2 discussion postmenopausal mole, should not be routine treatment, should be fully handled by erosion mole. Because postmenopausal women. Stop leaving the menstrual history is unclear, to the early diagnosis difficult. Two patients admitted to our hospital, curettage is a benign mole pathology test results and found no trophoblastic hyperplasia. Is also active in addressing timely. HCG has not returned to normal, but note (1) can not be based solely on the degree of trophoblastic proliferation to distinguish benign and malignant. (2) occurs in postmenopausal women with earlier onset of molar transfer characteristics. Because older postmenopausal women, poor physical tolerance of low boil, treatment, side effects occurred early and heavy, to the clinical treatment of difficult to improve the therapeutic effect of chemotherapy, the dose should be reasonable. Delivery time can not be arbitrarily extended. Because the patient has menopause, no reservation is necessary so the uterus and ovaries in 1 to 2 cycles of chemotherapy after hysterectomy and bilateral attachment removed. Chemotherapy can reduce the number of times. If no chemotherapy before surgery, may cause bloody spread.

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