Stovall T G, Ling F W, Buster J E
Division of Gynecology, University of Tennessee, Memphis.
Am J Obstet Gynecol. 1990 Jun;162(6):1620-3; discussion 1623-4. doi: 10.1016/0002-9378(90)90928-z.
The purpose of this study was to examine return of reproductive potential, hysterosalpingographic findings, and time to conception in patients treated with methotrexate and citrovorum factor for unruptured ectopic pregnancy. Fifty-seven patients with unruptured ectopic pregnancies less than 3.0 cm in greatest dimension were treated with methotrexate and citrovorum factor. The mean time from resolution of the ectopic pregnancy to return of menses was 26.0 (0 to 157) days. Forty-four patients were available for follow-up (2 to 15 months). Nineteen of 23 patients who had hysterosalpingograms demonstrated patency in the ipsilateral tube. Fourteen patients desired pregnancy; 11 of 14 (78.6%) were successful, with 10 of 11 (90.9%) having an intrauterine pregnancy, whereas one of 14 (9.1%) were extrauterine gestations. The mean time from first attempt to achieving pregnancy was 2.3 (1 to 4) months. We conclude that methotrexate and citrovorum factor treatment of unruptured ectopic pregnancy is associated with subsequent tubal patency and does not impair return of menses. Most importantly, the pregnancy rates after this form of therapy appear to be better than those achieved by traditional surgical methods, and are comparable to results after laparoscopic salpingostomy.
本研究的目的是探讨甲氨蝶呤和亚叶酸钙治疗未破裂型异位妊娠患者后生殖潜能的恢复情况、子宫输卵管造影结果以及受孕时间。57例最大直径小于3.0 cm的未破裂型异位妊娠患者接受了甲氨蝶呤和亚叶酸钙治疗。从异位妊娠消退到月经恢复的平均时间为26.0（0至157）天。44例患者可供随访（2至15个月）。23例行子宫输卵管造影的患者中有19例显示同侧输卵管通畅。14例患者希望怀孕；14例中的11例（78.6%）成功受孕，11例中的10例（90.9%）为宫内妊娠，而14例中的1例（9.1%）为宫外妊娠。从首次尝试到受孕的平均时间为2.3（1至4）个月。我们得出结论，甲氨蝶呤和亚叶酸钙治疗未破裂型异位妊娠与随后的输卵管通畅相关，且不影响月经恢复。最重要的是，这种治疗方式后的妊娠率似乎优于传统手术方法，且与腹腔镜输卵管造口术后的结果相当。
