Malignant hydatidiform mole

　　The true cause of malignant hydatidiform mole is still unclear. Various explanations have been proposed in literature, such as early embryonic death, the theory of second polar body replication, nutritional factors, and the theory of viral infection, but there is no conclusive evidence. Some scholars believe that the occurrence of hydatidiform mole is related to chromosomal abnormalities.

　　If there is uterine perforation, there may be abdominal pain, internal bleeding, and even shock. The hydatidiform mole can also metastasize to the lungs, causing hemoptysis; to the brain, it can cause symptoms of hemorrhage and even immediate death; to the intestines, it can cause gastrointestinal bleeding; to the vulva, vagina, and cervix, there are blue nodules locally, and the ulceration of nodules can cause massive bleeding.

　　Since hydatidiform mole is a disease caused by pregnancy, it can be avoided by implementing family planning and birth control measures, and reducing the number of pregnancies. Especially for women over 40, it is best not to become pregnant again, as advanced maternal age not only increases the risk of hydatidiform mole but also the risk of malignant transformation.

　　After hydatidiform mole occurs, one should be vigilant about postoperative malignant transformation. Closely observing the changes in HCG after curettage is the most important measure to prevent malignant transformation. If HCG remains above the normal level for more than 12 weeks after curettage, or if it has once dropped to the normal level and then rapidly increased, after excluding residual hydatidiform mole and re-pregnancy, it indicates that the patient is in the early stage of malignant hydatidiform mole, and chemotherapy should be given in a timely manner.

　　There is no ideal method to prevent the malignant transformation after hydatidiform mole surgery, but for high-risk patients with a tendency to malignant transformation, prophylactic chemotherapy may reduce the occurrence of malignant transformation. For those over 40 years old, the uterus is significantly larger than the menstrual period, reaching or exceeding 5 months in size, with an abnormally high HCG value greater than 105IU/L, and those living in remote areas and difficult to follow up, prophylactic chemotherapy can be adopted. Prophylactic chemotherapy should start 2 to 3 days before curettage. For those with hydatidiform mole mainly composed of small vesicles found during curettage, or hyperplasia of trophoblasts found in pathological examination, or with atypical hyperplasia, or HCG does not continue to decline after reaching a certain high value after curettage, selective chemotherapy can be adopted, which also has the effect of reducing malignant transformation.

　　1. Urine pregnancy test:After the hydatidiform mole is evacuated more than 2 months later, and confirmed by curettage that there is no residual vesicular fetal mass, while the urine pregnancy test remains positive, or becomes positive after being negative, there is a possibility of malignancy.

　　2. X-ray chest film: Patients with malignant hydatidiform mole often have lung metastasis, so for those with cough and hemoptysis, it is necessary to perform pulmonary examination. Cotton ball-like shadows can be seen in various parts of the lungs, especially in the lower lobe of the right lung, but those without pulmonary lesions cannot be ruled out as having invasive hydatidiform mole.

　　3. Diagnostic curettage:If there is only vaginal bleeding and other symptoms and signs are not typical, diagnostic curettage can be performed. If a small amount of decidua or necrotic tissue is scraped, it cannot be ruled out that there is invasive hydatidiform mole.

　　1. Sea cucumber stewed with Chinese yam and American ginseng

　　Prescription and usage: 96 grams of sea cucumber, 10 grams of American ginseng (separately packaged, only cooked for 15 minutes), 250 grams of pork backbone, 65 grams of Chinese yam, appropriate amounts of salt and peanut oil. First, cut the sea cucumber into small pieces, and place it with the chopped pork backbone in a large pot. Add Chinese yam and an appropriate amount of water, and simmer over low heat for 1 hour after the water boils. Then add slices of American ginseng, wolfberry, sesame oil, and salt, and simmer for another 15 minutes. Drink the soup in portions and eat the sea cucumber.

　　Efficacy: Prevents and treats cancer, invigorates Qi and enriches blood.

　　Evaluation: Sea cucumber has a mild nature, rich in protein, calcium, and iron. The mucopolysaccharides it contains can effectively enhance the body's immune function, inhibit the growth and prevent the metastasis of tumor cells, and the海参s it contains also have anticancer effects; American ginseng is slightly bitter and sweet, with a cool nature, and has the efficacy of nourishing Qi and Yin, clearing fire and generating saliva, especially suitable for those with deficiency of both Qi and Yin after radiotherapy and chemotherapy, who experience fatigue, thirst, dry tongue, and dizziness; Chinese yam has a sweet and neutral taste, invigorates Qi and nourishes Yin, and benefits the spleen and kidneys; Chinese wolfberry has a sweet and neutral taste, nourishes blood and benefits essence, protects the eyes and liver, and can alleviate the damage to the liver caused by chemotherapy drugs. Accompanied by pork backbone for nourishing the骨髓, it has the effects of preventing and treating cancer, invigorating Qi and enriching blood.

　　This recipe can also be used for common people to strengthen their health, and for women to nourish after their menstrual period.

　　Two, stir-fried eggplant with enoki mushrooms and goose blood

　　Prescription and usage: 125 grams of eggplant (cleaned, peeled, cut into pieces), 150 grams of enoki mushrooms (cleaned, cut into segments), 96 grams of goose blood. First, stir-fry the eggplant and enoki mushrooms with peanut oil and a little salt over low heat until they are seven or eight degrees cooked, then add the goose blood and quick stir-fry, and serve with dishes. Take 1-2 doses a day, and can be used continuously for 7-10 days, or can be alternated with other cancer prevention and treatment therapeutic recipes.

　　Effect: Blood-building, cancer prevention and treatment.

　　Evaluation: Eggplant is sweet and cool, rich in vitamin A, C, and E. The solanine it contains can inhibit the formation of digestive tract tumors and promote defecation, thus having the effects of cancer prevention and treatment; Enoki mushrooms are sweet and cool, with a protein content of more than 21%, containing 8 essential amino acids and various vitamins. They can induce the synthesis of interferon, thus having the effect of cancer prevention. They have an auxiliary therapeutic effect on breast cancer, lymphoma, and other diseases. Goose blood is slightly salty, containing vitamins and hemoglobin, which has a certain auxiliary therapeutic effect on esophageal cancer. The three cooked together can not only be used as a health and cancer prevention product but also as an effective therapeutic recipe for esophageal cancer and colorectal cancer.

　　Three, dietary taboos for malignant hydatidiform mole

　　1. In the early stage of hydatidiform mole, patients are basically no different from healthy people. At this time, there is no need to avoid certain foods.

　　2. In the late stage of hydatidiform mole, patients may show no appetite or difficulty in eating. At this time, there should be enough calories and protein, abundant vitamins, and attention should be paid to low-fat, low-sugar, and easily digestible foods to help patients absorb quickly.

　　Four, what kind of food is good for malignant hydatidiform mole

　　1. Fresh and hygienic foods should be chosen.

　　2. The variety of dishes should be rich, and it is best to have 'everything' in one meal, avoiding eating the same dish repeatedly.

　　3. The ratio of main and side dishes should be 1:1, the main dishes should be alternated with rice, flour, and mixed grains, and there should be coarse grains. The proportion of vegetables, fruits, and protein-containing foods in side dishes should be 5:1.

　　4. In protein foods, the ratio of animal protein to plant protein should be half and half, use less sweet and processed foods.

　　5. The fat intake should not exceed 509 grams per day, eat less meat, more fish and legumes, and try to choose foods that are beneficial for anti-cancer and cancer prevention.

　　1. Curettage

　　Due to the possibility of massive hemorrhage at any time for hydatidiform mole, it is necessary to remove the uterine contents promptly after diagnosis is confirmed, usually by vacuum aspiration. During the process of aspiration, the uterine body gradually shrinks and becomes firm. Although the aspirated material contains a large amount of blood, most of it is original blood in the uterine cavity, so the patient's pulse and blood pressure generally do not change significantly. Many people advocate that if the uterus exceeds the navel, a cesarean section should be performed to remove the hydatidiform mole, believing that this can thoroughly remove it under direct vision and stop bleeding effectively. However, in practice, even when the uterus is as large as seven or eight months of pregnancy, vacuum aspiration can still remove it successfully. If hysterectomy is required, it can be performed immediately after aspiration. Cesarean section for hydatidiform mole may反而 lead to the possibility of implantation and metastasis of hydatidiform mole. For those without vacuum aspiration equipment, the hydatidiform mole can be clamped after the cervix is dilated.

　　The first curettage does not need to be overly pursued for completeness to avoid injury to the softer uterine wall. A second curettage can be performed about a week later.

　　Patients who have undergone curettage treatment but still have uterine bleeding and seek medical attention should be treated according to the current situation. Suspected incomplete abortion of hydatidiform mole (incomplete aspiration or the production of new vesicular masses), a cautious and comprehensive curettage should be performed. If bleeding still occurs, it should be considered that the lesion has invaded the uterine wall, see malignant hydatidiform mole and choriocarcinoma. Women with spontaneous abortion of hydatidiform mole should also undergo curettage. There are different opinions on whether to administer uterine contraction agents intravenously during curettage. Opponents believe that uterine contraction agents can cause strong uterine contractions, forcing a large amount of villi of hydatidiform mole into the blood circulation, causing embolism or metastasis. Therefore, if the uterine contraction is good during the operation, routine administration of uterine contraction agents is not necessary; only when there is a lot of bleeding and poor uterine contraction, uterine contraction agents should be used.

　　2. Hysterectomy

　　Patients over 40 years of age, or those with rapid uterine growth after childbirth, should be advised to have a hysterectomy, and young patients may consider retaining the ovaries. Before the hysterectomy, patients with a uterus larger than 5 months of pregnancy should have most of the vesicular fetal masses in the uterine cavity removed vaginally to facilitate surgical treatment.

　　3. Blood Transfusion

　　Patients with severe anemia should be given small and frequent slow blood transfusions, and closely observe the patient for active bleeding. The operation of curettage should be performed after the condition improves to a certain extent. When active bleeding occurs, blood transfusion should be given at the same time as curettage.

　　4. Correct Electrolyte Disorders

　　Patients with long-term bleeding and loss of appetite often have dehydration and electrolyte disorders, which should be checked and corrected.

　　5. Control Infection

　　Long-term uterine bleeding, or those who have undergone repeated unclean operations, are prone to infection, manifested as local (uterus or adnexa) infection or sepsis. Sufficient anti-inflammatory drugs should be administered; and actively correct anemia and electrolyte disorders.