子宫内膜异位症生育指数在子宫内膜异位症合并不孕患者中的价值分析  

The value of endometriosis fertility index in patients with endometriosis and infertility

作　　者：朱学喆 李致远[1] 蔡炳昕 刘倩 王晓黎[1] Zhu Xuezhe;Li Zhiyuan;Cai Bingxin;Liu Qian;Wang Xiaoli(The First Gynecology Department,the Maternal and Child Health Hospital of Gansu Province,Gansu Lanzhou 730050)

机构地区：[1]甘肃省妇幼保健院妇一科,甘肃兰州730050

出　　处：《中国社区医师》2020年第16期101-102,104,共3页Chinese Community Doctors

基　　金：甘肃省自然科学基金项目(18JR3RA034)。

摘　　要：目的:探讨子宫内膜异位症(EMT)患者生育指数(EFI)对EMT合并不孕患者生育能力的评估。方法:选取2018年1月-2019年7月行腹腔镜手术治疗的EMT合并不孕患者137例,对术后累积妊娠相关性进行分析,对比不同类型EMT患者腹腔镜术后1~12个月、13~24个月及25~36个月的妊娠率。结果:137例患者经术后随访,3年内妊娠75例,其中自然妊娠63例,体外授精-胚胎移植妊娠12例;术后3年不包括体外受精-胚胎移植妊娠累积妊娠率为45.99%。术后3年累积妊娠率及EFI评分与促排卵质量具有正相关性,与r-AFS分期无显著相关性,与促性腺激素释放激素激动剂治疗无显著相关性。术后1~12个月妊娠率显著高于术后13~25个月及25~36个月,差异有统计学意义(P<0.05)。子宫腺肌病型EMT术后3年累积妊娠率显著低于其他分型,差异有统计学意义(P<0.05)。结论:对于EMT合并不孕患者,应参考EFI评分给予建议,对于EFI评分及预后较好的患者可以鼓励其接受治疗,提高治疗信心;对于部分EFI评分较差的患者可建议及早选择体外受精-胚胎移植方式治疗。Objective:To explore the valuation value of endometriosis(EMT)patients fertility index(EFI)for fecundity of patients with EMT and infertility.Methods:From January 2018 to July 2019,137 EMT patients with infertility undergoing laparoscopic surgery were selected,the correlation of cumulative pregnancy after operation was analyzed,we compared the pregnancy rates of EMT patients in different types at 1 to 12 months,13 to 24 months and 25 to 36 months after laparoscopic surgery.Results:137 cases were followed up and 75 cases were pregnant within 3 years,there were 63 cases of natural pregnancy and 12 cases of IVF-ET pregnancy.The cumulative pregnancy rate was 45.99%in 3 years after operation,excluding IVF-ET pregnancy.There was a positive correlation between the cumulative pregnancy rate in 3 years after operation and EFI score and the quality of ovulation,there was no significant correlation with r-AFS stage,there was no significant correlation with GnRH agonist therapy.The pregnancy rate of 1 to 12 months after operation was significantly higher than that of 13 to 25 months and 25 to 36 months after operation,the difference was statistically significant(P<0.05).In adenomyosis EMT,the cumulative pregnancy rate of 3 years after operation was significantly lower than that of other types,the difference was statistically significant(P<0.05).Conclusion:For EMT patients with infertility,we should refer to EFI score to give suggestions,for patients with better EFI score and better prognosis,we can encourage them to receive treatment and improve treatment confidence.For some patients with poor EFI scores,we can suggest early selection of IVF-ET.

关 键 词：子宫内膜异位症 生育指数 不孕 腹腔镜手术 

分 类 号：R711.71[医药卫生—妇产科学] R711.6[医药卫生—临床医学]