EFI评分对子宫内膜异位症不孕妇女腹腔镜术后自然妊娠的预测价值  

Value of EFI score in predicting natural pregnancy of infertile women with endometriosis after laparoscopic surgery

作　　者：易金玲[1] 史松[1] 刘雁林[1] 冯文广[1] 

机构地区：[1]新疆医科大学第五附属医院妇科,新疆乌鲁木齐830011

出　　处：《中国妇幼保健》2015年第27期4604-4606,共3页Maternal and Child Health Care of China

基　　金：新疆维吾尔自治区自然科学基金〔2014211C123〕

摘　　要：目的通过对比研究,探讨子宫内膜异位症生育指数（EFI）对子宫内膜异位症（EMs）不孕妇女的腹腔镜术后自然妊娠率的预测意义。方法以该院2011年1月-2014年1月执行腹腔镜治疗的230例EMs相关不孕病患为研究对象,依照手术发现执行EFI评分,随访其妊娠情况和结局。对不同EFI分值的病患自然妊娠率进行比较,采用Kaplan-Meier生存分析法计算累积妊娠率并进行比较。结果 182例完成随访的病患的总妊娠率为56.04%（102/182）。EFI评分8-10分者的总妊娠率为54.90%（56/102）,其中8、9、10分的妊娠率分别为53.66%（22/41）、51.06%（24/47）和64.29%（9/14）,各分值间比较差异无统计学意义（P=0.216）。EFI 7分者的妊娠率为40.63%（13/32）,低于8-10分者,差异有统计学意义（P=0.033）;EFI 4-6分的妊娠率为20.93%（9/43）,4、5、6分的妊娠率分别为22.22%（2/9）、21.43%（3/14）和20.00%（4/20）,各分值间比较差异无统计学意义（P=0.655）,显著低于7分者（P=0.000）。EFI 0-3分的妊娠率为0.00%（0/5）。术后不同时间的妊娠率差异有统计学意义（P=0.000）。r-AFS分期Ⅰ-Ⅳ期的妊娠率分别为Ⅰ期45.24%（19/42）、48.00%（24/50）、44.00%（22/50）45.00%（18/40）,各期间差异无统计学意义（P=0.921）。结论 EFI能较好地预测接受腹腔镜手术的EMs相关不孕病患的术后生育力,值得临床推广运用。Objective To explore the value of endometriosis fertility index（ EFI） in predicting natural pregnancy rate of infertile women with endometriosis after laparoscopic surgery by a comparative study. Methods A total of 230 infertile women with endometriosis treated by laparoscopic surgery in the hospital from January 2011 to January 2014 were selected,FEI score was performed according to laparoscopic surgery,the pregnancy situations and outcomes were followed up. The natural pregnancy rates of patients with different FEI scores were compared,Kaplan- Meier survival analysis method was used to calculate cumulative pregnancy rate,then the results were compared. Results Among 182 patients completing follow- up,the total pregnancy rate was 56. 04%（ 102 /182）. The total pregnancy rate of patients with EFI score 8- 10 was 54. 90%（ 56 /102）,the pregnancy rates of patients with EFI score 8,9,and 10 were 53. 66%（ 22 /41）,51. 06%（ 24 /47）,and 64. 29%（ 9 /14）,respectively,there was no statistically significant difference（ P = 0. 216）. The pregnancy rate of patients with EFI score 7 was 40. 63%（ 13 /32）,which was statistically significantly lower than that of patients with EFI score 8- 10（ P =0. 033）; the total pregnancy rate of patients with EFI score 4- 6 was 20. 93%（ 9 /43）,the pregnancy rates of patients with EFI score 4,5,and 6 were 22. 22%（ 2 /9）,21. 43%（ 3 /14）,and 20. 00%（ 4 /20）,respectively,there was no statistically significant difference（ P =0. 655）,the total pregnancy rate of patients with EFI score 4- 6 was statistically significantly lower than that of patients with EFI score 7（ P = 0. 000）. The total pregnancy rate of patients with EFI score 0- 3 was 0. 00%（ 0 /5）. There was statistically significant difference in pregnancy rate among different postoperative time points（ P = 0. 000）. The pregnancy rates of patients of r- AFS stage Ⅰ- Ⅳ were45. 24%（ 19 /42）,48. 00%（ 24 /50）,44. 00%（ 22 /50）,and 45. 00%（ 18 /40）,respectively,ther

关 键 词：子宫内膜异位症生育指数 子宫内膜异位症 腹腔镜治疗 不孕 

分 类 号：R711.6[医药卫生—妇产科学]