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腹腔镜治疗子宫内膜异位症患者的临床结局分析及生殖结局与子宫内膜异位症生育指数的相关性:一项回顾性队列研究

Clinical Outcome Analysis and Correlation of Reproductive Outcome with Endometriosis Fertility Index in Laparoscopically Managed Endometriosis Patients: A Retrospective Cohort Study.

作者信息

Negi Neha, Roy Kallol Kumar, Kumar Sunesh, Nair Vinod G, Vanamail P

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Hum Reprod Sci. 2019 Apr-Jun;12(2):98-103. doi: 10.4103/jhrs.JHRS_157_18.

Abstract

BACKGROUND

Laparoscopy is important for management of endometriosis patients with estimation of endometriosis fertility index (EFI) which can predict reproductive outcome.

AIMS

This study aims to evaluate clinical outcome in laparoscopically managed pelvic endometriosis and correlation of reproductive outcome with EFI.

SETTING AND DESIGN

Retrospective cohort study carried out in the Department of Obstetrics and Gynecology.

MATERIALS AND METHODS

Our study included 123 patients who had undergone laparoscopic management of endometriosis from January 2017 to March 2018. Case files were retrieved and meticulously analyzed. All patients were contacted and interviewed. Symptomatic relief and pregnancy in infertility patients were recorded. EFI was calculated.

STATISTICAL ANALYSIS

Data analyses were carried out using statistical software STATA version 12.0. < 0.05 was considered statistically significant.

RESULTS AND CONCLUSIONS

A total of 123 cases were enrolled; the most common complaint was infertility 107 (86.99%); the mean age was 32.4 years. EFI was found to be (6 to 10) in 28(26.2%) patients, EFI of (4 to 5) in 49 (45.8%) and EFI of (0 to 3) in 30 (28.0%). Post surgery, dysmenorrhoea was relieved in 56 (65.88%) patients, menstrual irregularities were relieved in 45 (76.27 %) patients, dyspareunia in 32 (54.24%) and chronic pelvic pain in 24 (40.5%) patients. 8 (40%) patients with low EFI conceived, 20 (58.82%) with moderate, and 26 (96.29%) with high EFI conceived. EFI score showed statistically significant positive correlation with pregnancy outcome = 0.001, higher the EFI score, better the reproductive outcome. Laparoscopic surgeries are important for managing patients of endometriosis. It provides significant symptomatic relief, and EFI estimation can be done, which is a good tool to predict reproductive outcome of infertility patients with endometriosis.

摘要

背景

腹腔镜检查对于子宫内膜异位症患者的管理很重要,可用于评估子宫内膜异位症生育指数(EFI),该指数能够预测生殖结局。

目的

本研究旨在评估腹腔镜治疗盆腔子宫内膜异位症的临床结局以及生殖结局与EFI的相关性。

设置与设计

在妇产科进行的回顾性队列研究。

材料与方法

我们的研究纳入了2017年1月至2018年3月间接受腹腔镜治疗子宫内膜异位症的123例患者。检索并详细分析病例档案。与所有患者进行联系和访谈。记录症状缓解情况以及不孕患者的妊娠情况。计算EFI。

统计分析

使用统计软件STATA 12.0进行数据分析。P<0.05被认为具有统计学意义。

结果与结论

共纳入123例病例;最常见的主诉是不孕,共107例(86.99%);平均年龄为32.4岁。发现28例(26.2%)患者的EFI为(6至10),49例(45.8%)患者的EFI为(4至5),30例(28.0%)患者的EFI为(0至3)。术后,56例(65.88%)患者痛经得到缓解,45例(76.27%)患者月经不调得到缓解,32例(54.24%)患者性交困难得到缓解,24例(40.5%)患者慢性盆腔疼痛得到缓解。EFI低的患者中有8例(40%)受孕,EFI中等的患者中有20例(58.82%)受孕,EFI高的患者中有26例(96.29%)受孕。EFI评分与妊娠结局呈统计学显著正相关(P = 0.001),EFI评分越高,生殖结局越好。腹腔镜手术对于子宫内膜异位症患者的管理很重要。它能显著缓解症状,并且可以进行EFI评估,这是预测子宫内膜异位症不孕患者生殖结局的良好工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff67/6594121/adfcd04bafeb/JHRS-12-98-g001.jpg

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