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目的探讨氟尿嘧啶(5-FU)、更生霉素(KSM)、长春新碱(VCR)、环磷酰胺(CTX)四联化疗方案治疗恶性滋养细胞肿瘤的临床疗效及不良反应。方法5-FU 26 mg·kg~(-1)·d~(-1)+5%葡萄糖注射液500 ml,8 h均速静脉滴注,KSM 6μg·kg~(-1)·d~(-1)+5%葡萄糖注射液200 ml静脉滴注1 h。第1天化疗时,提前3 h加用VCR 2 mg+0.9%氯化钠注射液30 ml静脉滴注,第2、4天加用CTX 300 mg+0.9%氯化钠注射液500 ml静脉滴注2 h。5 d为1个疗程,间隔2周。其中手术20例,手术方式为子宫次广泛切除+卵巢动静脉高位结扎,年轻患者保留单侧卵巢或双侧卵巢。结果51例患者中44例接受本方案治疗而获治愈,总治愈率86.08%,其中8例Ⅲ期患者(15.68%)获治愈。主要不良反应为骨髓抑制、口腔黏膜溃疡及胃肠道反应。结论5-FU、KSM、VCR、CTX联合治疗方案不良反应小,疗效好,疗程短,患者费用降低。
Objective To investigate the clinical effects and adverse reactions of 5-FU, KSM, VCR and CTX chemotherapy in the treatment of malignant trophoblastic tumor. Methods 500 ml of 5-FU 26 mg · kg -1 d -1 and 5% glucose injection were injected intravenously at 8 h and KSM 6 μg · kg -1 · d ~ (-1) -1) + 5% glucose injection 200 ml intravenous infusion 1 h. On the first day of chemotherapy, 3 ml of VCR 2 mg + 0.9% sodium chloride injection 30 ml was given intravenously in advance, and CTX 300 mg + 0.9% sodium chloride injection 500 ml intravenously Note 2 h. 5 d for a course of treatment, interval of 2 weeks. Of which surgery in 20 cases, the surgical approach was extensive subtotal uterine resection + high ligation of the ovarian artery and vein, young patients retained unilateral or bilateral ovary. Results Of the 51 patients, 44 patients received the treatment and were cured, the total cure rate was 86.08%, of which 8 cases of stage Ⅲ patients (15.68%) were cured. The main adverse reactions were myelosuppression, oral mucosal ulceration and gastrointestinal reactions. Conclusions 5-FU, KSM, VCR, CTX combined treatment regimens have small adverse reactions, good curative effect, short course of treatment and lower cost of patients.