摘要
目的:分析子宫内膜异位症生育指数(EFI)评分对子宫内膜异位症(EMT)不孕妇女腹腔镜术后自然妊娠的预测价值。方法:选取2013年7月-2016年7月本院收治的EMT不孕患者255例,均实施保守性腹腔镜手术,根据病史和手术发现行EFI评分,随访2年妊娠情况,分析比较EFI不同分值、r-AFS分期及联合药物治疗患者的自然妊娠情况。结果:255例中30例失访,15例术后行辅助生殖技术予以排除,共210例随访完成136例自然受孕。EFI评分越高,自然妊娠率越高,6个月内妊娠率高于7~24个月,当EFI评分在7~10时,随时间延长妊娠率降低(P<0.05);r-AFS不同分期患者2年内妊娠率比较未见差异(P>0.05),r-AFS I期、II期和III期患者随术后时间延长妊娠率降低,r-AFSIV期时趋势不明显;GnRH-a组自然妊娠率高于无药物治疗及孕三烯酮、避孕药类治疗(P<0.05),无药物治疗或GnRH-a治疗患者,随术后时间延长妊娠率降低,孕三烯酮和避孕药类治疗则无明显趋势。结论:EFI对EMT不孕患者腹腔镜术后自然妊娠的预测优于r-AFS评分,可为临床治疗方案的确定提供参考。
Objective:To analyze the value of endometriosis fertility index(EFI)score for predicting natural pregnancy of infertility women because of endometriosis after laparoscopic surgery.Methods:A total of 255 infertility women because of endometriosis from July 2013 to July 2016 were enrolled to receive conservative laparoscopic surgery.The EFI scores were obtained according to the medical history and surgery.The pregnancy status of all women after operation was followed up for 2 years.The natural pregnancy situation of these women with different EFI scores,r-AFS staging,and combination therapy was analyzed.Results:Among these 255 women,30 cased were lost to follow-up,and 15 cases were excluded due to assisted reproductive technology,so 210 women had completed followed up,and 136 women in these 210 cases had pregnancy naturally.The higher the EFI score of women was,the higher the natural pregnancy rate had.The pregnancy rate of women within 6 months after operation was significant higher than that of women within 7-24 months after operation.As the EFI score was 7-10 points,the pregnancy rate of women had decreased with the prolongation of time after operation gradually(P<0.05).There was no significant difference in the pregnancy rate of women with different staging of r-AFS within 2 years after operation(P>0.05).The pregnancy rate of women with r-AFS stage I,II or III decreased gradually with the prolongation of time after operation,but that of women with r-AFS stage IV had no changed.The natural pregnancy rate of women with GnRH-a treatment was significant higher than that of women without drug treatment,or with gestrinone or contraceptives treatments(P<0.05).The pregnancy rate of women with GnRH-a treatment or without treatment had decreased gradually with the prolongation of time after operation,but that of women with gestrinone or contraceptives treatment had no changed.Conclusion:The value of EFI score for predicting natural pregnancy of infertility women because of endometriosis after laparoscopic surgery is supe
作者
夏莹
周晓莉
刘杰
刘韵
兰艳丽
XIA Ying;ZHOU Xiaoli;LIU Jie;LIU Yun;LAN Yanli(Central Theater General hospital of PLA, Wuhan, Hubei Province, 430070;Xiangyang Central hospital)
出处
《中国计划生育学杂志》
2020年第11期1876-1879,1883,共5页
Chinese Journal of Family Planning
