Blister Mass Surgery

Blister-type block surgery is used for surgical treatment of trophoblastic diseases. In many cells that make up the human body, the trophoblast is a very special cell. Its tissue source, developmental process, morphological variation and biological characteristics are different from those of normal cells. The most peculiar thing is that it also has the ability to erode the body. A trophoblastic tumor is a tumor formed by changes in trophoblast cells, including invasive moles and choriocarcinoma, or choriocarcinoma. In the past, surgery and radiation therapy have been considered as the main treatment, but the effect is very poor. Since the successful use of chemical drugs to treat trophoblastic tumors, the curative effect of erosive mole or choriocarcinoma has been significantly improved. The erosive hydatidiform moles are basically dead, the mortality of choriocarcinoma is also reduced, and the mortality rate in high-risk and advanced patients is also reduced to less than 20%. More than 80% to 90% of patients have reached radical cure. Therefore, surgery and radiotherapy have gradually relegated to a secondary position. Many patients can be cured with only simple medical treatment, without surgery, while retaining fertility, normal pregnancy and childbirth, and obtaining healthy offspring. However, in some specific cases, surgical treatment still plays an important role, such as life-saving in emergency, recurrence of resection in chemotherapy, identification of disease staging, assisting drug treatment, shortening chemotherapy time, and reducing serious complications of chemotherapy. Both the disease and the correct judgment of prognosis play an important role. Curing disease: Indication 1, irregular bleeding after amenorrhea, abnormal uterus, soft, when the increase of more than 5 months, still can not hear the fetal heart, can not understand the fetal position. 2, the vaginal discharge of blood mixed with vesicles. 3, HCG determination of hydatidiform mole secretion of HCG, for early diagnosis and differential diagnosis is of great significance. 4, B-ultrasound see the uterus filled with long light, there is a typical snow-like image (Leopold, 1974) without carcass and placental reflex, in recent years due to the use of vaginal probe to diagnose the hydatidiform mole from 11 to 13 weeks pregnant 8 weeks pregnant. Preoperative preparation 1, blood and blood before surgery, establish an intravenous infusion channel, ready for blood transfusion at any time. 2. If you suspect that you have an infection, you can use antibiotics before surgery. 3. If the patient's diagnosis is inaccurate or suspect, surgery can be performed under B-monitoring. Surgical procedure 1, bladder lithotomy position, emptying the bladder, routine disinfection of the vulva and vagina, disinfection towel. 2, put a speculum, comprehensive examination of the cervix, vaginal area with or without abnormal lesions. Find out the size, location, and texture of the uterus. 3, before the beginning of the suction of the palace to measure the pulse, blood pressure and breathing, to maintain a stable state before surgery. 4, generally do not need to expand the cervix, a very small number of primiparas or long-lost uterine cervix closed, need to expand the cervix, but should be strictly guard against perforation. 5, because the hydatidiform uterus is too large, the texture is soft, generally do not probe the depth of the uterine cavity, it is easy to perforate or cause massive bleeding. 6. Check the suction device for negative pressure before inhaling the palace, adjust the suction of the negative pressure to prevent the suction force from being too large and hurt the wall of the palace. 7, should choose a larger straw to reduce the hydatid tissue blocking the lumen. The straw enters the middle of the uterine cavity and stops. It should not reach the bottom to prevent perforation or negative pressure adsorption from injuring the bottom of the palace. 8, the process of inhalation is slow, when the uterus begins to shrink, add 10U oxytocin in the glucose solution to accelerate tissue absorption and strengthen uterine contraction to reduce bleeding. It also prevents the hydatid tissue from squeezing into the sinus of the uterus 9. When the straw feels that the uterus has been initially exhausted and the uterus has contracted significantly without active bleeding, it can be scraped with a large blunt curette. If no tissue is scraped and there is no bleeding, the operation can be stopped. 10. After the operation, the vital signs were measured. The total volume of the tissue and blood was measured and recorded. The size of the grapes in the tissue was carefully observed and recorded. All scrapings were sent for pathological examination.

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