Lipscomb Gary H, Meyer Norman L, Flynn Darby E, Peterson Matt, Ling Frank W
Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, USA.
Am J Obstet Gynecol. 2002 Jun;186(6):1192-5. doi: 10.1067/mob.2002.123825.
The purpose of this study was to evaluate oral methotrexate tablets in the treatment of ectopic pregnancy.
Patients with a diagnosis of ectopic pregnancy were offered oral methotrexate tablets rather that intramuscular injection. Oral methotrexate was given in 2 divided doses 2 hours apart at a dose of 60 mg/m(2) with standard 2.5 mg methotrexate tablets. Patients were followed up with the use of the same protocol that was used typically for intramuscular methotrexate.
Nineteen of 22 patients (86%) were successfully treated. There was no statistical difference between patients who were treated successfully or unsuccessfully, with respect to initial human chorionic gonadotropin titers (P =.55), ectopic size (P =.77), or methotrexate dose (P =.18). Nineteen of 22 patients (86%) had increased pain during treatment. Outside of pain, gastrointestinal side effects were the most common. Thirty-two percent of patients required more than one treatment cycle.
Oral methotrexate can be used to treat ectopic pregnancy successfully, but there are few advantages to recommend its use over intramuscular methotrexate.
本研究旨在评估口服甲氨蝶呤片治疗异位妊娠的效果。
诊断为异位妊娠的患者接受口服甲氨蝶呤片而非肌肉注射治疗。口服甲氨蝶呤以60mg/m²的剂量分2次服用，间隔2小时，使用标准的2.5mg甲氨蝶呤片。患者按照通常用于肌肉注射甲氨蝶呤的相同方案进行随访。
22例患者中有19例（86%）成功治愈。成功治疗和未成功治疗的患者在初始人绒毛膜促性腺激素水平（P = 0.55）、异位妊娠包块大小（P = 0.77）或甲氨蝶呤剂量（P = 0.18）方面无统计学差异。22例患者中有19例（86%）在治疗期间疼痛加剧。除疼痛外，胃肠道副作用最为常见。32%的患者需要不止一个治疗周期。
口服甲氨蝶呤可成功用于治疗异位妊娠，但与肌肉注射甲氨蝶呤相比，推荐使用它的优势不多。
