Yeko T R, Mayer J C, Parsons A K, Maroulis G B
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
Obstet Gynecol. 1995 Feb;85(2):265-8. doi: 10.1016/0029-7844(94)00347-G.
To evaluate the safety and efficacy of hyperosmolar glucose injection in select unruptured tubal gestations with hCG levels less than 2500 mIU/mL.
In this prospective series, 16 patients with an hCG titer less than 2500 mIU/mL and an unruptured ectopic pregnancy were treated by tubal injection with hyperosmolar (50%) glucose. Hyperosmolar glucose was injected transabdominally into the antimesenteric site of the tubal pregnancy, using a 20-gauge spinal needle. The main outcome measures evaluated were duration of surgery, success rate, time to resolution, and follow-up tubal patency rates.
Ninety-four percent (15) of the subjects were treated successfully with a median time to resolution of 24 days (range 5-78). The one treatment failure required methotrexate because of rising hCG titers and worsening pain 4 days after the patient was treated with hyperosmolar glucose. The mean (+/- standard error) duration of surgery was 45 +/- 6 minutes. So far, all ten patients undergoing postoperative hysterosalpingograms have demonstrated tubal patency in the treated tube.
Laparoscopic injection with hyperosmolar glucose is an effective, systemically nontoxic alternative treatment for select unruptured ectopic pregnancies (hCG less than 2500 mIU/mL) that achieves tubal patency rates comparable to other conservative medical and surgical treatments.
评估高渗葡萄糖注射液对人绒毛膜促性腺激素（hCG）水平低于2500 mIU/mL的未破裂输卵管妊娠的安全性和有效性。
在这个前瞻性系列研究中，16例hCG滴度低于2500 mIU/mL且未破裂的异位妊娠患者通过经输卵管注射高渗（50%）葡萄糖进行治疗。使用20号脊椎穿刺针经腹部将高渗葡萄糖注射到输卵管妊娠的系膜对侧部位。评估的主要结局指标包括手术时长、成功率、消退时间以及随访时的输卵管通畅率。
94%（15例）的受试者治疗成功，消退的中位时间为24天（范围5 - 78天）。1例治疗失败，该患者在接受高渗葡萄糖治疗4天后，因hCG滴度升高和疼痛加剧而需要使用甲氨蝶呤。手术的平均（±标准误）时长为45 ± 6分钟。到目前为止，所有接受术后子宫输卵管造影的10例患者，其治疗侧输卵管均显示通畅。
对于部分未破裂的异位妊娠（hCG低于2500 mIU/mL），腹腔镜注射高渗葡萄糖是一种有效的、全身无毒的替代治疗方法，其输卵管通畅率与其他保守药物和手术治疗相当。
