Kojima E, Abe Y, Morita M, Ito M, Hirakawa S, Momose K
1st Department of Obstetrics and Gynecology, Toho University School of Medicine, Tokyo, Japan.
Obstet Gynecol. 1990 Apr;75(4):723-5.
Nine patients with unruptured tubal pregnancies of 6-9 weeks' duration were treated with methotrexate intratubal injection under laparoscopic control. Urinary hCG levels decreased immediately after completion of the procedure, with a median time of 11 days (range 1-29) to resolution. Tubal patency on the side of the ectopic gestation was confirmed by hysterosalpingography 1-3 months after the procedure in all cases. This method requires a reduced methotrexate dosage compared with intramural or intravenous therapy. The indications are unruptured tubal pregnancy of 4 cm or less in diameter and urinary hCG levels of 8000 mIU/mL or lower.
9例输卵管妊娠未破裂、病程6 - 9周的患者在腹腔镜控制下接受了甲氨蝶呤输卵管内注射治疗。治疗完成后尿hCG水平立即下降，中位降至正常时间为11天（范围1 - 29天）。术后1 - 3个月，所有病例均通过子宫输卵管造影证实异位妊娠侧输卵管通畅。与肌内或静脉注射治疗相比，该方法所需的甲氨蝶呤剂量减少。适应证为直径4 cm或更小的输卵管妊娠未破裂且尿hCG水平在8000 mIU/mL或更低。
