Fifteen patients with laparoscopically diagnosed tubal pregnancy and constant or rising plasma beta-hCG levels were treated with prostaglandin F2 alpha and prostaglandin E2. Prostaglandin F2 alpha (5 mgms diluted in 10 cc of isotonic sodium solution) was injected transabdominally with a 22 gauge spinal needle during laparoscopy into the Fallopian tube. Prostaglandin E2 (500 micrograms ms) was given intramuscularly during three consecutive postoperative days. The treatment was defined as successful if plasma beta-hCG levels declined below the lower limit of detection and no further intervention other than prostaglandin application was required. The treatment was successful in eight patients. Six patients underwent laparotomy and salpingotomy because of rising beta-hCG levels. None of the treated patients displayed any adverse reactions following prostaglandin F2 alpha application. One patient underwent explorative laparotomy during the second postoperative day because of lower abdominal pain. During operation, no pathological change could be found. This patient was excluded from the study. In the group treated successfully (n = 8) seven out of eight patients had beta-hCG levels below 2500 mlU/ml preoperatively. In the unsuccessfully treated group (n = 6), four out of six patients had beta-hCG levels above 2500 mlU/ml preoperatively. Mean duration of beta-hCG decline to 10 percent of the maximum preoperative value was 15.8 +/- 8.64 days (mean +/- S.D.). Postoperatively, hysterosalpingography was performed in six out of eight successfully treated patients after three menstrual cycles (one patient had an intrauterine pregnancy, one patient refused written consent). The Fallopian tubes were patent bilaterally in all six patients.

译文

用前列腺素f2α 和前列腺素e2治疗15例经腹腔镜诊断为输卵管妊娠且血浆 β-hCG水平持续或升高的患者。在腹腔镜检查期间,将前列腺素f2α (在10 cc的等渗钠溶液中稀释的5 mgms) 用22号脊柱针经腹注射到输卵管中。在术后连续三天肌肉注射前列腺素E2 (500微克ms)。如果血浆 β-hCG水平下降到检测下限以下,并且除前列腺素应用外不需要进一步干预,则治疗被定义为成功。八名患者的治疗成功。由于 β-hCG水平升高,六名患者接受了剖腹手术和输卵管切开术。在应用前列腺素f2α 后,治疗的患者均未显示任何不良反应。由于腹痛较低,一名患者在术后第二天接受了探索性剖腹手术。术中未见病理改变。该患者被排除在研究之外。在成功治疗的组中 (n = 8),八名患者中有七名术前 β-hCG水平低于2500 mlU/ml。在未成功治疗组 (n = 6) 中,六名患者中有四名术前 β-hCG水平高于2500 mlU/ml。Β-hCG下降至最大术前值10% 的平均持续时间为15.8 +/- 8.64天 (平均值 +/-s.d.)。术后,在三个月经周期后,八名成功治疗的患者中有六名进行了子宫输卵管造影 (一名患者宫内妊娠,一名患者拒绝书面同意)。所有六名患者的输卵管均双侧未闭。

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