葡萄胎处理原则Grape Tyre treatment principle

葡萄胎很少术前出血，预防清宫术中大出血才是重点。术前用米非司酮和MTX杀胚化疗，使滋养细胞全部或部分坏死，HCG大幅度下降后，再行清宫出血会明显减少。远比术后化疗效果好。如果术前杀胚化疗效果不理想，也要宫腹腔镜联合手术：先在腹腔镜下解剖子宫动脉用钛夹夹闭A再吸宫，术后确定不出血或放好cook球囊后，再放开子宫A，这样万无一失。根据病理决定下一步治疗。

Grape fetal bleeding is rarely preoperative, the prevention of massive bleeding is the focus. Preoperative chemotherapy with mifepristone and MTX to kill embryos causes all or part of the trophoblast. After the HCG is greatly reduced, the bleeding in the Qinggong will be significantly reduced. Far better than post-operative chemotherapy. If the preoperative embryogenic chemotherapy is not ideal, it is also necessary to perform combined laparoscopic surgery: first dissect the uterine artery under the laparoscope and clamp A with titanium clip and then suck the palace. After the operation, it is determined that there is no bleeding or after placing the cookie balloon, then release the uterus A. This is foolproof. According to the pathology, the next treatment is decided.