Guo Yuyan, Huang Penghui, Liu Chaobin, Wang Zhenna, Wang Yi, Qi Wei, Xie Xi, Wang Zhenhong, Zhang Jinna, Lin Shunhe
Department of Physical Examination Center, Fujian Medical University Union Hospital, Fujian, China.
Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, Fujian, China.
Sci Rep. 2025 Jan 7;15(1):1139. doi: 10.1038/s41598-024-84370-8.
This study aims to evaluate whether laparoscopic surgery enhances health-related quality of life (HRQoL) in endometriosis patients, utilizing the Endometriosis Health Profile-30 (EHP-30) questionnaire. The study also explores the correlations between disease severity, preoperative scores, and the subsequent changes following surgical intervention. This is a prospective observational study. Seventy women undergoing laparoscopic surgery for endometriosis at Fujian Maternity and Child Health Hospital were prospectively recruited. Each participant was assessed using the EHP-30 questionnaire both 4 weeks prior to and 3 months post-surgery to obtain preoperative and postoperative subscale scores. The Wilcoxon signed-rank test was applied to determine the statistical significance of changes in these scores. Spearman's rank correlation coefficient was employed to explore the relationships between preoperative EHP-30 scores, serum CA125 levels, and intraoperative revised American Society for Reproductive Medicine (rASRM) scores. Statistically significant correlations were further examined using multivariate linear regression analysis to adjust for potential confounders. Laparoscopic surgery resulted in a significant reduction in EHP-30 subscale scores (P ≤ 0.002), indicating a marked improvement in HRQoL among endometriosis patients. Spearman correlation analysis revealed positive correlations between preoperative serum CA125 levels (P = 0.005) and intraoperative rASRM scores with preoperative pain (P = 0.035) and sexual intercourse scores (P = 0.046). Additionally, multivariate linear regression analyses demonstrated that changes in pain scores (ΔPain), control and powerlessness (ΔControl and Powerlessness), and work life (ΔWork Life) were significantly interrelated (P < 0.01). Emotional well-being (ΔEmotional Well-being), control and powerlessness (ΔControl and Powerlessness), and work life (ΔWork Life) also exhibited significant mutual influences (P < 0.01). Furthermore, changes in social support (ΔSocial Support), self-image (ΔSelf-image), and treatment perception (ΔTreatment) were positively correlated (P < 0.01), as were changes in sexual intercourse (ΔSexual Intercourse) and concern about infertility (ΔConcern on Infertility) (P < 0.01). Laparoscopic surgery for endometriosis significantly improves HRQoL by alleviating pain and positively influencing daily functioning and emotional well-being. These findings highlight the critical role of laparoscopic surgery as an effective intervention for enhancing the quality of life in endometriosis patients.
本研究旨在利用子宫内膜异位症健康概况-30(EHP-30)问卷评估腹腔镜手术是否能提高子宫内膜异位症患者的健康相关生活质量(HRQoL)。该研究还探讨了疾病严重程度、术前评分与手术干预后后续变化之间的相关性。这是一项前瞻性观察性研究。前瞻性招募了70名在福建省妇幼保健院接受腹腔镜手术治疗子宫内膜异位症的女性。每位参与者在手术前4周和手术后3个月均使用EHP-30问卷进行评估,以获得术前和术后各分量表得分。应用Wilcoxon符号秩检验来确定这些得分变化的统计学意义。采用Spearman等级相关系数来探讨术前EHP-30得分、血清CA125水平与术中修订的美国生殖医学学会(rASRM)得分之间的关系。使用多元线性回归分析进一步检验具有统计学意义的相关性,以调整潜在的混杂因素。腹腔镜手术导致EHP-30分量表得分显著降低(P≤0.002),表明子宫内膜异位症患者的HRQoL有明显改善。Spearman相关性分析显示术前血清CA125水平(P = 0.005)以及术中rASRM得分与术前疼痛(P = 0.035)和性交得分(P = 0.046)之间呈正相关。此外,多元线性回归分析表明疼痛得分变化(Δ疼痛)、控制与无助感(Δ控制与无助感)以及工作生活(Δ工作生活)之间存在显著的相互关系(P < 0.01)。情绪幸福感(Δ情绪幸福感)、控制与无助感(Δ控制与无助感)以及工作生活(Δ工作生活)之间也表现出显著的相互影响(P < 0.01)。此外,社会支持变化(Δ社会支持)、自我形象(Δ自我形象)和治疗认知(Δ治疗认知)之间呈正相关(P < 0.01),性交变化(Δ性交)和对不孕的担忧(Δ对不孕的担忧)之间也呈正相关(P < 0.01)。子宫内膜异位症的腹腔镜手术通过减轻疼痛并对日常功能和情绪幸福感产生积极影响,显著改善了HRQoL。这些发现突出了腹腔镜手术作为提高子宫内膜异位症患者生活质量的有效干预措施的关键作用。