DiMarchi J M, Cyka R E
Department of Obstetrics and Gynecology, Malcolm Grow Medical Center, Andrews Air Force Base, Maryland.
J Reprod Med. 1992 Jul;37(7):659-60.
Persistent ectopic pregnancy complicates a significant percentage of conservative tubal pregnancy procedures. The optimal treatment of persistent trophoblast has yet to be determined. Most reported cases have been treated by reoperation and removal of the affected tube. Use of methotrexate may avoid the need for reoperation and permit tubal salvage. We report on a case of persistent ectopic pregnancy treated successfully using an oral methotrexate regimen originally described for treating nonmetastatic gestational trophoblastic neoplasia. Oral methotrexate provides a simple, convenient, outpatient treatment option for cases of persistent ectopic pregnancy diagnosed by a rise or plateau in human chorionic gonadotropin levels following conservative surgery.
持续性异位妊娠在很大比例的保守性输卵管妊娠手术中会出现并发症。持续性滋养细胞的最佳治疗方法尚未确定。大多数报道的病例都是通过再次手术切除患侧输卵管来治疗的。使用甲氨蝶呤可能避免再次手术的需要，并能保留输卵管。我们报告了一例使用最初描述用于治疗非转移性妊娠滋养细胞肿瘤的口服甲氨蝶呤方案成功治疗的持续性异位妊娠病例。对于保守手术后人绒毛膜促性腺激素水平升高或平稳而诊断为持续性异位妊娠的病例，口服甲氨蝶呤提供了一种简单、方便的门诊治疗选择。
