Cymbaluk-Płoska Aneta, Chudecka-Głaz Anita, Kuźniak Sławomir, Menkiszak Janusz
Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
Open Med (Wars). 2016 Dec 16;11(1):530-536. doi: 10.1515/med-2016-0091. eCollection 2016.
Detectability of early stages of ectopic pregnancies has increased due to improvements in ultrasonographic and biochemical techniques. Since the patients' future procreative plans must be taken into consideration when commencing treatment, the goal of this work was to compare the effects of treatment methods and their impact on fertility. The study included 91 patients treated surgically for ectopic pregnancy. The choice of treatment depended on patients' general condition, ultrasonographic evaluation and serum level of beta-hCG. A combination of laparoscopic and conservative systemic treatment was applied in 70% of cases. More rapid beta-hCG reduction was noted when laparoscopy and intra-oviductal injection of hyperosmolar glucose or methotrexate (MTX) were combined with intramuscular administration of MTX at a dose of 50 mg/m2. Follow-up examination of 66 patients revealed that the greatest number of spontaneous pregnancies (48%) resulted after this combination therapy. We conclude that this combination treatment is safe and provides satisfactory results in terms of future fertility.
由于超声检查和生化技术的改进，异位妊娠早期的可检测性有所提高。由于在开始治疗时必须考虑患者未来的生育计划，因此本研究的目的是比较治疗方法的效果及其对生育能力的影响。该研究纳入了91例接受手术治疗的异位妊娠患者。治疗方法的选择取决于患者的一般状况、超声检查评估以及β - hCG的血清水平。70%的病例采用了腹腔镜与保守全身治疗相结合的方法。当腹腔镜检查与输卵管内注射高渗葡萄糖或甲氨蝶呤（MTX），并联合肌肉注射剂量为50mg/m²的MTX时，β - hCG下降更快。对66例患者的随访检查发现，这种联合治疗后自然妊娠的数量最多（48%）。我们得出结论，这种联合治疗是安全的，并且在未来生育能力方面能提供令人满意的结果。
