甲氨蝶呤治疗输卵管妊娠后的再孕率分析

目的 总结甲氨蝶呤（MTX）治疗输卵管妊娠后的再孕率。方法 收集我院1985年3月至1999年8月确诊为未破裂输卵管妊娠、有生育要求的患者129例，中期60例为MTX全身治疗成功，69例为患侧输卵管切除，按每5年1个时间段回顾分析，随诊1－15年。结果 MTX治疗者，宫内妊娠73％（44例），异位妊娠8％（5例）；输卵管切除者，宫内妊娠70％（48例），异位妊娠4％（3例）。两者比较，差异无显著性（P＞0．05）。结论 MTX保守治疗的效果和一侧输卵管切除术相似，没有提高再孕率。

Analysis of pregnancy rates after treatment of tubal pregnancy with systemic methotrexate

OBJECTIVE: To analyse the pregnancy rate after treatment of tubal pregnancy with the systemic methotrexate (MTX) injection. METHODS: From March 1985 to August 1999, 129 women with confirmed unruptured tubal pregnancy, and desiring to conceive were selected. Among them 60 women were successfully treated with systemic MTX, and 69 with unilateral salpingectomy. All cases were followed up for 1-15 years. RESULTS: The rates of subsequent intrauterine pregnancies (IUP) in the MTX group was 73% (44 cases) and of recurrent extrauterine pregnancies (EP) was 8% (5 cases). Among 69 patients treated by salpingectomy, the rates of IUP and EP was 70% (48 cases) and 4% (3 cases) respectively. The differences between the two groups were not statistically significant. CONCLUSIONS: The effect of conservative management with MTX was similar to those of salpingectomy. The rate of subsequent pregnancy did not increased.