妊娠合并恶性肿瘤的临床研究

Clinical Study on Pregnancy Complicated with Malignant Tumor

目的:总结中国人民解放军总医院(我院)妊娠合并恶性肿瘤患者的诊治经过及胎儿、孕妇预后,探讨此类疾病特点,以降低漏诊率,提高诊疗效率和母婴预后。方法:回顾性分析我院2010—2016年诊断为妊娠合并恶性肿瘤的22例患者的临床资料并对患者进行随访。结果:妊娠合并恶性肿瘤最多的系统前4位分别是消化系统(6例,肝癌、胃癌各3例),生殖系统(5例,宫颈癌1例,卵巢癌4例),血液系统(3例,均为白血病),免疫系统(3例,均为恶性淋巴瘤)。5例患者放弃妊娠,其余孕期行肿瘤手术者3例,行化疗治疗1例,同时行剖宫产和肿瘤手术者5例。12例患者未行规律产检。初次确诊时有8例(36.4%)已处于肿瘤Ⅳ期,产后患者预后差。活产胎儿81.25%(13/16)为早产儿、75.0%(12/16)为低出生体质量儿。结论:妊娠合并恶性肿瘤需适时终止妊娠、多科室协作,早诊断是关键。

Objective： To analyze the clinical data, diagnosis, treatment and outcome of pregnancycomplicated with malignant tumor, as a reference for clinic to reduce the missed diagnosis and improve maternal and infant prognosis. Methods： A total of 22 pregnant patients complicated with malignant tumor were retrospectively analyzed who were treated in our hospital from 2010 to 2016. Results： High incidence of malignant tumors encountered systems in those pregnant patients were the digestive system neoplasm （n=6）, the genital system tumor （n=5）,the hematological malignancy and the immune system tumors （n=3）. Five patients terminated pregnancy,three patients underwent surgical treatment and 1 patient had chemotherapy. Five patients underwent cesarean section and tumor surgery at the same time. Twelve patients did not have their regular prenatal examination. Unfortunately,eight patients （36.4%） suffered from tumors at Ⅳ stage, with poor prognosis after delivery. The ratio of premature infants was 81.25% （13/16）,and the ratio of low birth weight infants 75.0% （12/16）. Conclusions： As the treatment strategy,those pregnancy patients complicated with malignant tumor should be duly terminated pregnancy,and be treated with an interdisciplinary cooperation. Importantly,early diagnosis is the key.