Jiménez-Caraballo A, Rodríguez-Donoso G
Departamento de Ginecología y Obstetricia, Hospital Universitario Virgen Macarena, Seville, Spain.
Eur J Obstet Gynecol Reprod Biol. 1998 Aug;79(2):167-71. doi: 10.1016/s0301-2115(98)00036-0.
Our aim was to assess the efficiency of methotrexate therapy for unruptured ectopic pregnancy.
From November 1990 to December 1996, 60 patients diagnosed with unruptured ectopic pregnancies were treated by the Departamento de Ginecología y Obstetricia at the Hospital Virgen Macarena of Seville. Of these, 14 patients received an intrasacular injection of 15 mg of methotrexate, 45 were given an intramuscular dose of 50 mg/m2 and only one received the drug by both routes.
Forty-six patients (76.7%) responded successfully to treatment. Of these, 10 had been given the drug intrasacularly (10/15, 66.7%), while 36 had received the drug intramuscularly (36/46, 78.3%). Twenty patients (33.3%) had minor side effects, the most frequent being mild abdominal pain. Falling levels of leukocytes on the third day after initiation of treatment may serve as a fairly accurate criterion to predict the patient's response to the treatment.
Our data support the use of methotrexate therapy as a reliable alternative to surgical intervention in the treatment of unruptured ectopic pregnancy. Intramuscular administration, without laparoscopy, appears to be the most convenient route as it is easily implemented and has comparatively few complications.
我们的目的是评估甲氨蝶呤治疗未破裂异位妊娠的疗效。
1990年11月至1996年12月，塞维利亚马卡雷纳圣母医院妇产科对60例诊断为未破裂异位妊娠的患者进行了治疗。其中，14例患者接受了15毫克甲氨蝶呤的囊内注射，45例接受了50毫克/平方米的肌肉注射，只有1例通过两种途径给药。
46例患者（76.7%）治疗成功。其中，10例接受了囊内给药（10/15，66.7%），36例接受了肌肉注射（36/46，78.3%）。20例患者（33.3%）有轻微副作用，最常见的是轻度腹痛。治疗开始后第三天白细胞水平下降可作为预测患者对治疗反应的相当准确的标准。
我们的数据支持使用甲氨蝶呤治疗作为未破裂异位妊娠手术干预的可靠替代方法。在不进行腹腔镜检查的情况下进行肌肉注射似乎是最方便的途径，因为它易于实施且并发症相对较少。
