子宫内膜异位症生育指数(EFI)对EMs相关不孕妇女腹腔镜术后自然妊娠的预测价值  

Predictive value of endometriosis fertility index for pregnant rate after laparoscopy in EMs-associated infertile patients

作　　者：张向卉[1] 冯雪[1] 黄薇[1] 王秋石[1] 刘冬[1] 谭婧[1] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041

出　　处：《现代妇产科进展》2014年第12期968-970,975,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨子宫内膜异位症生育指数(EFI)对EMs相关不孕患者腹腔镜术后自然妊娠率的预测价值。方法:回顾分析2008年1月至2012年3月于我院行腹腔镜治疗的730例EMs相关不孕患者,根据手术发现进行EFI评分,并随访其妊娠情况和妊娠结局。比较不同EFI分值患者的自然妊娠率,Kaplan-Meier生存分析法计算累积妊娠率,采用Log-rank检验进行比较。结果:完成随访的548例患者的总妊娠率为43.43%(238/548)。EFI评分8~10分者的总妊娠率为54.55%(168/308),8、9、10分的妊娠率分别为53.66%(66/123)、51.75%(74/143)和66.67%(28/42),各分值间比较差异无统计学意义(P=0.225)。EFI 7分者的妊娠率为42.27%(41/97),低于8~10分者,差异有统计学意义(P=0.035);EFI 4~6分的妊娠率为21.71%(28/129),4、5、6分的妊娠率分别为17.86%、19.05%和25.42%,各分值间比较差异无统计学意义(P=0.638),显著低于7分者(P=0.000)。EFI 0~3分的妊娠率为7.14%(1/14)。术后不同时间的妊娠率有统计学差异(P=0.000)。r-AFS分期I^IV期的妊娠率分别为45.23%(57/126)、47.33%(71/150)、44.08%(67/152)和44.17%(53/120),无统计学差异(P=0.939)。结论:EFI能较好地预测接受腹腔镜手术的EMs相关不孕患者的术后生育力。Objective：To confirm the predictive value of endometriosis fertility index （EFI） for women with endometriosis-associated infertility. Methods ：730 infertile patients with endometriosis who underwent laparoseopy from Jan. 2008 to March 2012 were analyzed retrospectively. EFI score was recorded according to medical history and intra-operative findings. The pregnancy outcome after surgery was followed-up. Comparisons of different score with cumulative pregnancy rate （PR） were performed by Х^2-test. The survival curves were got by Kaplan- Meier method and validated by Log-rank test. Results：The total PR was 43.43% among remaining 548 patients （238/548）. The aggregated PR was 54.55% among EFI 8 - 10 patients （168/308）, and there were no significant difference among different EFI score （53.66%, 51.75% ,66.67% ; P = 0. 225 ）. The PR was 42.27% （41/97） in EFI score 7, which lower than those with EFI 8 - 10 （ P = 0. 035 ）, but higher than that of EFI 4 - 6 （21.71% ,28/129 ; P = 0. 035 ）. There were no significant difference of cumulative PR among EFI 4,5 and 6 （ 17.86% , 19.05% ,25.42% ;P= 0. 638 ）. In total of 14 EFI 0 - 3 women, only one pregnant was completed. Kaplan-Meier survival analysis about PR in different time among EFI 8 - 10,7, 4 - 6,0 - 3 was statistic significance （P = 0. 000）. However, the PR in r-AFS staging （ Ⅰ - Ⅳ） was no significant difference （45.23% ,47.33% ,44.08% ,44. 17%, P = 0. 939 ）. Conclusion：Compared with other staging system, EFI can better predict women＇s fecundity in endometriosis-associated infertile women with treatment of laparoscopy.

关 键 词：子宫内膜异位症 不孕 腹腔镜治疗 子宫内膜异位症生育指数 

分 类 号：R713.7[医药卫生—妇产科学]