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[子宫内膜异位症生育指数在腹腔镜手术后子宫内膜异位症合并不孕患者随访治疗中的评估]

[Evaluation of endometriosis fertility index in follow-up treatment of endometriosis combined with infertility patients after laparoscopic surgery].

作者信息

Qian R Y, Wu X, Sheng J, Zheng P, Zhou Q, Duan A H, Zhang J P, Zhang Y L, Lu D

机构信息

Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2017 Apr 25;52(4):233-238. doi: 10.3760/cma.j.issn.0529-567X.2017.04.004.

Abstract

To explore the application of endometriosis fertility index (EFI) in guidance after laparoscopic surgery of endometriosis patients combined with infertility and to explore methods to improve pregnancy rate in different EFI groups. A prospective research was done in endometriosis patients combined with infertility in Beijing Obstetrics and Gynecology Hospital from January 2010 to June 2011, after laparoscopic surgery, these 146 patients were divided into 3 groups by EFI score. Using different pregnancy guidance, these patients had 5 years follow-up. (1) The 5 years overall pregnancy rate was 89.0% (130/146). The pregnancy rate was 95.7% (45/47) in EFI≥9 group, 92.8% (77/83) in EFI 5-8 group and 8/16 in EFI≤4 group, three groups were all reach satisfactory pregnancy rate; the rate of the first two groups had no statistically significance (0.498), but had significant difference with the last group (0.01). (2) In EFI≥5 patients, pregnancy rate was the highest in 6 months after operation; in EFI≥9 group, the pregnancy rate was 66.7% (30/45), and EFI 5-8 group was 50.6% (39/77). (3) EFI≥9 group had the highest natural pregnancy rate [83.6% (46/55)], natural pregnancy rate was significant statistical different in different EFI groups (0.001). EFI score is a useful evaluation in predicting and guiding pregnancy in endometriosis patients combined with infertility after laparoscopic surgery. EFI score guidance, strict post-operation management and positive pregnancy scheme could significantly improve the pregnancy rate of endometriosis patients with infertility.

摘要

探讨子宫内膜异位症生育指数(EFI)在子宫内膜异位症合并不孕患者腹腔镜手术后指导中的应用,并探索提高不同EFI组妊娠率的方法。2010年1月至2011年6月在北京妇产医院对子宫内膜异位症合并不孕患者进行前瞻性研究,腹腔镜手术后,将这146例患者按EFI评分分为3组。采用不同的妊娠指导,对这些患者进行5年随访。(1)5年总妊娠率为89.0%(130/146)。EFI≥9分组妊娠率为95.7%(45/47),EFI 5-8分组为92.8%(77/83),EFI≤4分组为8/16,三组妊娠率均达到满意水平;前两组之间无统计学差异(0.498),但与最后一组有显著差异(0.01)。(2)EFI≥5的患者术后6个月妊娠率最高;EFI≥9组妊娠率为66.7%(30/45),EFI 5-8组为50.6%(39/77)。(3)EFI≥9组自然妊娠率最高[83.6%(46/55)],不同EFI组自然妊娠率有显著统计学差异(0.001)。EFI评分在预测和指导腹腔镜手术后子宫内膜异位症合并不孕患者妊娠方面是一种有用的评估方法。EFI评分指导、严格的术后管理和积极的妊娠方案可显著提高子宫内膜异位症不孕患者的妊娠率。

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