Suzuki Takahiro, Izumi Shun-Ichiro, Awaji Hideo, Matsubayashi Hidehiko, Yoshikata Kikuo, Kika Goh, Murano Takayo, Shida Masako, Uchida Noa, Cai Liyi, Kondo Mayu, Yoshitake Tomoko, Makino Tsunehisa
Department of Obstetrics and Gynecology, Specialized Clinical Medicine, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2004 Dec;29(4):183-9.
To evaluate methotrexate (MTX) administration as a conservative treatment for ectopic pregnancy, we reviewed the medical records of 248 cases (210 patients) of MTX treatment for tubal pregnancies at our department between December 1985 and December 2003, and compared its pregnancy prognosis with that of laparoscopic salpigotomy (59 patients). With the MTX treatment, 185 patients were successfully treated, and the subsequent pregnancy rate and ectopic pregnancy rate were 48.4 % and 18.4 %, respectively, while those rates were 49.2 % and 18.6 %, respectively, after the salpigotomy. These results suggest that MTX treatment is comparable to the more conservative operation. To clarify the (dys/) function of the ectopic implantation tubes and MTX-treated tube (s), we excluded patients who had a contra-lateral healthy tube, and extracted 40 patients as "the affected tube group", where the pregnancy-related parameters were not adversely affected. The findings suggest that MTX is not necessary to preserve tubal function.
为评估甲氨蝶呤（MTX）给药作为异位妊娠保守治疗方法的效果，我们回顾了1985年12月至2003年12月间在我院接受MTX治疗输卵管妊娠的248例（210名患者）的病历，并将其妊娠预后与腹腔镜输卵管切开术（59名患者）的进行比较。采用MTX治疗时，185例患者成功治愈，后续妊娠率和异位妊娠率分别为48.4%和18.4%，而输卵管切开术后的相应比率分别为49.2%和18.6%。这些结果表明，MTX治疗与更为保守的手术效果相当。为阐明异位着床输卵管及经MTX治疗的输卵管的（功能）异常，我们排除了对侧输卵管健康的患者，选取40例患者作为“患侧输卵管组”，该组中与妊娠相关的参数未受到不利影响。研究结果表明，MTX并非保留输卵管功能所必需。
