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自从1883年Lawson 成功地做了第一例输卵管妊娠手术以后,手术治疗一直是处理异位妊娠的主要手段。近10余年来随着保守手术的开展,异位妊娠的非手术疗法也越来越多的应用于临床。受MTX 治疗滋养细胞疾病的启迪,1965年Hreshchyshyn 等用MTX 治疗一例腹腔妊娠患者,该患者剖腹取胎后胎盘未能取出,后经过MTX 治疗,胎盘蜕变坏死,二次手术在未造成严重出血的情况下成功的取出胎盘。1982年Tanak 用MTX 成功地治疗了输卵管间质部妊娠,1983年Farabow 报道应用MTX 治疗一例子宫颈妊娠。由于B 超的问世及β-hCG 放射免疫测定法的普及应用,输卵管妊娠未破裂型诊断的准确率已可达100%,因此,输卵管妊娠的化疗以其独特的治疗效果被一些著者推荐。化疗的适应证:化疗可应用于各种类型的异位妊娠,如间质部妊娠,宫颈妊娠,未破裂型输卵管妊娠,卵巢妊娠,腹腔妊娠等。对输卵管妊娠流产,内出血量不多hCG 仍为阳性者也可应用,但应严密观察。化疗药物:首选药物为氨甲喋呤(MTX),目前国外关于异位妊娠化疗的报导,多数都是选用MTX,国内也有报导应用5-氟脲嘧啶(5-Fu)治疗异位妊娠
Surgery has been the primary treatment for ectopic pregnancy since Lawson succeeded in making the first tubal pregnancy in 1883. Nearly 10 years with the development of conservative surgery, ectopic pregnancy non-surgical treatment is also more and more used in clinical. By MTX treatment of trophoblastic disease enlightenment, Hreshchyshyn et al 1965 MTX treatment of a case of abdominal pregnancy patients, the patient cesarean section after removal of the placenta failed to remove, after MTX treatment, placental necrosis, the second operation in the absence of severe bleeding The case of successful removal of the placenta. In 1982, Tanak successfully treated tubal pregnancy with MTX. In 1983, Farabow reported the use of MTX to treat one case of cervical pregnancy. Due to the advent of B ultrasound and the popularization and application of β-hCG radioimmunoassay, the accuracy of unruptured tubal pregnancy diagnosis has reached 100%. Therefore, chemotherapy for tubal pregnancy is recommended by some authors for its unique therapeutic effect. Chemotherapy indications: chemotherapy can be applied to various types of ectopic pregnancy, such as interstitial pregnancy, cervical pregnancy, unruptured tubal pregnancy, ovarian pregnancy, abdominal pregnancy and so on. Tubal pregnancy miscarriage, small amount of internalized blood is still positive for hCG can also be applied, but should be closely observed. Chemotherapy drugs: the preferred drug for methotrexate (MTX), the current foreign reports on the treatment of ectopic pregnancy, the majority are selected MTX, there are also reports of domestic use of 5-fluorouracil (5-Fu) treatment of ectopic pregnancy