Miyazaki Y, Shiina Y, Wake N, Okada Y, Yamazaki H, Takeda W, Ichinoe K
Nihon Sanka Fujinka Gakkai Zasshi. 1983 Apr;35(4):489-97.
8 cases of tubal pregnancy in the pre-abortional stage were detected by B-scope examination. The administration of MTX (total doses: 60-300mg) resulted in complete remission in 7 cases; the other received tubectomy because of the progression of abortion. The dose of MTX used to obtain remission is responsible for the HCG titer of urine before the treatment; 60-150mg of MTX was sufficient in cases which showed a titer below 1,000iu/l, although 75-300mg was necessary in cases over 4,000iu/l. The patency of tubes after the regimen was confirmed in 4 out of 5 cases with hystero-salpingography. Serious side effects were not observed in the present study in spite of the great efficacy; transient suppression of liver has been observed in 2 cases. Two patients had normal intra-uterine pregnancy subsequent to the treatment; one had a matured full-term female neonate and the other received D & C in 9 gestational weeks. These results suggest that the MTX regimen is practical for the treatment of patients with tubal pregnancy. This is characterized by unimpaired fertility following the treatment, although the detection of patients in the pre-abortional stage is absolutely necessary.
通过B超检查发现8例输卵管妊娠处于流产前阶段。给予甲氨蝶呤（总剂量：60 - 300mg）治疗后，7例完全缓解；另1例因流产进展而行输卵管切除术。用于获得缓解的甲氨蝶呤剂量与治疗前尿HCG滴度有关；尿滴度低于1000iu/l的病例，60 - 150mg甲氨蝶呤就足够了，而滴度超过4000iu/l的病例则需要75 - 300mg。5例中有4例在子宫输卵管造影术后证实输卵管通畅。尽管疗效显著，但本研究中未观察到严重的副作用；2例出现短暂的肝功能抑制。两名患者在治疗后有正常的宫内妊娠；一名产下一名成熟的足月女婴，另一名在妊娠9周时接受了刮宫术。这些结果表明，甲氨蝶呤方案对输卵管妊娠患者的治疗是可行的。其特点是治疗后生育能力不受影响，不过绝对有必要在流产前阶段检测出患者。
