宫腔注射氨甲喋呤治疗输卵管妊娠

Treatment of Tubal Pregnancy by Intrauterine Injection of Methotrexate

探讨保守治疗异位妊娠以达到最低限度的外科干预和药物不良反应，提供新的治疗方法。方法采用宫腔注射氨甲喋呤（ＭＴＸ），以血清β－绒毛膜促性腺激素（β－ＨＣＧ）水平评价治疗效果，β－ＨＣＧ下降至正常值（＜３．１ｎｇ／ｍｌ）为治愈。结果１６例中输卵管妊娠１５例，宫角妊娠１例，均为未破裂型。治疗后７２ｈ血清β－ＨＣＧ水平下降较治疗前有显著差异（Ｐ＝０．０３３），治愈１５例（９３．７％），失败１例（６．３％）。住院天数４～２２ｄ，平均１１．５ｄ。结论对患者无损伤，药物不良反应小，方法简便。

Purpose Investigation of a new conservative procedure for the treatment of ectopic pregnancy in order to minimize surgical intervention and drug side effects. Methods ① Intrauterine injection of methotrexate (MTX).② Evaluation of therapeutic effects by measurement of serum β HCG level.Decline of serum β HCG following treatment indicating the therapy is effective,while return of β HCG to normal (<3.1 ng/ml) indicating the treatment is successful. Results 16 cases of ectopic tubal pregnancy are chosen for the present study.The results of treatment are:15 successful (93.7%),1 failure (6.3%). Conclusions The advantaged of intrauterine MTX injection for the treatment of ectopic tubal pregnancy are: no damage to the patient;mild drug side effects;simple and easy procedure.Therefore,cases of unruptured tubal pregnancy located in isthmus,interstitial or uterine cornual portins with serum β HCG less than 10 ng/ml are considered to be the priority of this treatment.