清宫术前应用天花粉蛋白治疗葡萄胎的疗效分析

Efficacy of Trichosanthin Injection before Dilation and Curretage in the Treatment of Hydatidiform Mole

目的:探讨清宫术前注射天花粉蛋白治疗葡萄胎的临床疗效。方法:回顾分析2003年1月—2013年4月上海交通大学医学院附属瑞金医院收治的48例葡萄胎患者的临床资料,根据治疗方法的不同将患者分为天花粉组(n=23)和对照组(n=25)。天花粉组患者清宫术前先肌内注射天花粉蛋白注射液,待组织物排出后再行清宫术;对照组仅行清宫术。比较两组患者术中出血量、手术时间,术后出血天数、二次清宫率、术后血清β-人绒毛膜促性腺激素(beta-human chorionic gonadotropin,β-HCG)水平下降至正常水平所需时间及葡萄胎恶变率。结果:与对照组相比,天花粉组清宫术中出血量、手术时间,术后出血天数、二次清宫率及术后血清β-HCG下降至正常水平所需时间均显著减少或降低(均P<0.01),但两组葡萄胎恶变率差异则无统计学意义(P>0.05)。结论:清宫术前应用天花粉蛋白注射液治疗葡萄胎疗效显著,可用于辅助治疗葡萄胎。

Objective：To investigate the clinical efficacy of trichosanthin injection in patients with hydatidiform mole before di- lation and curettage（D C）. Methods： The clinical data collected from 48 patients with hydatidiform mole hospitalized in Ruijin Hospital, School of Medicine, Shanghai Jiaotong University from January to April 2013 was retrospectively analyzed. Those patients were randomly divided into treatment group（n = 23） and control group（n = 25）. The patients in the treatment group were intramuscularly injected with trichosanthin, and D C was performed after the main tissues came out. Patients in the con- trol group underwent D C. The differences in the blood loss volume during operation, operation time, post-operative bleeding time, efficient rate for secondary curettage,the time needed for beta-human chorionic gonadotropin （β-HCG） returning back to normal level, and the malignant rate were compared between the two groups. Results： Compared with the control group, all those indexes except the last one were significantly decreased （P〈0.01）. Conclusions： Trichosanthin should be injected intra- muscularly before D C to help patients with hydatidiform mole.