妇产科精品课件-妊娠滋养细胞疾病(英文).ppt

;;Clinical Features of GTN;Work-up for GTN;Ultrasound;Chest X-Ray; The Staging of GTN（FIGO 2000）;Modified WHO Risk Factor Scoring System; Chemotherapy (Cure rate 92%) Low risk－single drug, i.e. MTX or Act-D or VP-16. High risk or resistance－EMA-CO, or based on 5-Fu Regression－疗程结束18天内血 ?-hCG下降至少1个对数 停药指征－ 低危： 血?-hCG连续3周阴性后＋1疗程 高危： 血?-hCG阴性，症状体征消失＋2~3疗程 手术／放疗为辅 Salvage chemotherapy：EP-EMA，PVB，BEP，VIP等 ;EMA/CO; Surgery： Hysterectomy. Surgical removal of lesions in uterus. Pulmonary lobectomy. Radiation For mets in the liver or brain For chemo-resistant lesion in the lung;Follow-up of GTN;PSTT;Sonographic appearance of PSTT;Management of PSTT;Summary;Quiz Discussion;QUIZ;GTD最常继发于下列哪种情况？ A. Molar pregnancy B. Normal pregnancy C. Abortion D. Ectopic pregnancy. ;监测和随访GTD时需检测下列哪个指标？ A. CA125 B. β-HCG C. AFP D. hPL ;下列叙述哪些是正确的？ A. Partial moles are of paternal origin, are diploid, and carry a 20% risk of GTD sequelae. ? B. Complete moles are of maternal and paternal origin, are triploid, and rarely are followed by GTD. C. Partial moles require the same follow-up for potential malignant sequelae as a complete mole. D. The diagnosis of a molar pregnancy can be established with ultrasonography and may coexist with a normal pregnancy. ?;下列哪种方法处理葡萄胎最安全有效？ A. Hysterectomy B. Suction curettage C. Chemotherapy D. Radiotherapy ;下面哪种情况不是葡萄胎的并发症？ A. Anemia B. Toxemia C. Hypothyroidism D. Hyperemesis gravidarum E. Cardiac failure F. Pulmonary insufficiency.;有关低危与高危型GTD的描述，下列哪些是正确的？ A. Low-risk categories receive single agent chemotherapy, usually methotrexate. B. High-risk patients receive combination chemotherapy, usually EMA/CO. ? C. Low-risk patients have a cure rate of less than 90%. D. Patients with high-risk metastatic GTD can not be treated. ? ;GTD的患者治疗结束后需避孕多长时间才能再怀孕？ A. 2 months. B. 6 to 12 months. ? C. 1 to 2 years. D. 3 to 5 years. ;(Doubilet P, Benson C: Atlas of Ultrasound and Obstetric Gynecology. Philadelphia, Lippincott Williams and Wilkins, 2003.) ;;Refe