Pansky M, Bukovsky I, Golan A, Herman A, Hertziano I, Langer R, Caspi E
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
Int J Gynaecol Obstet. 1992 Apr;37(4):265-70. doi: 10.1016/0020-7292(92)90327-f.
Fifty-nine women with early unruptured tubal pregnancy were treated by a single local injection of methotrexate at laparoscopy. All 59 patients underwent the procedure without any adverse reaction, 47 (80%) of them needing no laparotomy. Twelve patients required a laparotomy for reasons such as rising beta-hCG levels and abdominal pain with or without rising levels of beta-hCG. Only one patient ruptured the tube. None of the women needed a blood transfusion. We found tubal patency in 19 out of 21 patients at follow up hysterosalpingography. Eleven pregnancies were subsequently reported, one of them tubal. The appearance of the injected tube was absolutely normal in three patients, one at cesarean section and two at repeated laparoscopy. No peritubal adhesions were observed. We suggest that this new technique is a safe and effective alternative to laparotomy in a patient with an early unruptured tubal pregnancy.
59例早期未破裂输卵管妊娠患者在腹腔镜下行甲氨蝶呤单次局部注射治疗。所有59例患者均顺利接受该手术，无任何不良反应，其中47例（80%）无需剖腹手术。12例患者因β-人绒毛膜促性腺激素（β-hCG）水平升高和腹痛（无论β-hCG水平是否升高）等原因需要剖腹手术。仅1例患者输卵管破裂。所有女性均无需输血。在随访子宫输卵管造影检查中，我们发现21例患者中有19例输卵管通畅。随后报告了11次妊娠，其中1次为输卵管妊娠。3例患者注射侧输卵管外观完全正常，1例在剖宫产时发现，2例在重复腹腔镜检查时发现。未观察到输卵管周围粘连。我们认为，对于早期未破裂输卵管妊娠患者，这项新技术是一种安全有效的替代剖腹手术的方法。
