Laatikainen T, Tuomivaara L, Käär K
Department of Obstetrics and Gynecology, Oulu University Central Hospital, Finland.
Fertil Steril. 1993 Jul;60(1):80-4. doi: 10.1016/s0015-0282(16)56040-3.
To compare a local injection of hyperosmolar glucose and salpingostomy for the laparoscopic treatment of tubal pregnancy in terms of immediate success and postoperative tubal patency.
Prospective. PATIENTS, SETTING: Forty women with an unruptured tubal pregnancy were enrolled from among 117 women with ectopic pregnancies (EPs) admitted consecutively to the university clinic. The inclusion criteria were as follows: [1] concentration of beta-hCG in the serum < or = 5,000 IU/L; [2] no living fetus in the EP; and [3] unruptured tubal pregnancy at laparoscopy.
After randomization, 20 of these patients were treated with a local injection of hyperosmolar (50%) glucose solution and 20 women by salpingostomy. Tubal patency was evaluated at relaparoscopy or by hysterosalpingography 6 to 13 months after the primary treatment.
The mean decrease in beta-hCG concentration from the preoperative value to the first postoperative day was 37% and 52% in the glucose and salpingostomy groups, respectively, and the mean resolution time was 13 and 12 days, respectively. Human chorionic gonadotropin showed a persistent EP in 4 women (20%) in the glucose group and 2 (10%) in the salpingostomy group. A patent treated tube was found in 9 of 13 women in the glucose group and 9 of 10 in the salpingostomy group at re-examination. During a follow-up of 6 to 20 months 4 women in the glucose group and 4 women in the salpingostomy group had an intrauterine pregnancy.
A local injection of hyperosmolar glucose is a reasonable method treating tubal pregnancy in selected cases but does not seem to offer any advantage over salpingostomy concerning persistent trophoblastic disease rate.
比较局部注射高渗葡萄糖与输卵管造口术在腹腔镜治疗输卵管妊娠中的即时成功率及术后输卵管通畅情况。
前瞻性研究。
患者、研究地点：从连续入住大学诊所的117例异位妊娠（EP）女性中纳入40例未破裂输卵管妊娠女性。纳入标准如下：[1]血清β - hCG浓度≤5000 IU/L；[2]EP中无存活胎儿；[3]腹腔镜检查时输卵管妊娠未破裂。
随机分组后，其中20例患者接受局部注射高渗（50%）葡萄糖溶液治疗，20例女性接受输卵管造口术治疗。在初次治疗后6至13个月通过再次腹腔镜检查或子宫输卵管造影评估输卵管通畅情况。
葡萄糖组和输卵管造口术组β - hCG浓度从术前值至术后第一天的平均下降率分别为37%和52%，平均消退时间分别为13天和12天。葡萄糖组4例（占20%）女性和输卵管造口术组2例（占10%）女性的人绒毛膜促性腺激素显示持续性EP。复查时，葡萄糖组13例女性中有9例治疗后的输卵管通畅，输卵管造口术组10例中有9例通畅。在6至20个月的随访期间，葡萄糖组4例女性和输卵管造口术组4例女性发生宫内妊娠。
局部注射高渗葡萄糖在特定病例中是治疗输卵管妊娠的合理方法，但在持续性滋养细胞疾病发生率方面似乎并不比输卵管造口术有任何优势。
