不同临床病理类型子宫内膜异位症合并不孕患者生育力的研究

发布时间：2018-11-18 08:50

【摘要】：目的探讨腹腔镜手术联合药物治疗对子宫内膜异位症(endometriosis,EMT)合并不孕患者生育力的影响。方法回顾分析我院和广州医科大学第三附属医院腹腔镜手术联合药物治疗且资料完整的110例EMT合并不孕的临床资料,采用子宫内膜异位症生育指数(endometirosis fertility index,EFI)评分评估手术对术后妊娠的影响。结果 EFI评分9~10分(高)39例,5~8分(中)35例,≤4分(低)36例。术后3年自然妊娠率47.3%(52/110),应用克罗米芬组3年自然妊娠率为67.9%(35/53)明显高于非克罗米芬组29.8%(17/57)(χ~2=14.449,P=0.000)。EFI评分单纯腹膜型与腺肌病型比较差异有统计学意义(q=4.446,P0.05),内囊型与腺肌病型比较差异有统计学意义(q=4.505,P0.05)。术后自然妊娠率单纯腹膜型明显高于腺肌病型(χ~2=6.549,P=0.010),内囊型明显高于腺肌病型(χ~2=6.144,P=0.013)。结论 EMT合并不孕患者在腹腔镜手术时采用EFI评估生育力,以指导选择个体化的后续治疗方案;EFI评分低的患者不建议通过长期等待来提高妊娠率,克罗米芬的应用可提高患者的自然妊娠率。
[Abstract]:Objective to investigate the effect of laparoscopic surgery combined with drug therapy on fertility in patients with endometriosis (endometriosis,EMT) complicated with infertility. Methods the clinical data of 110 cases of EMT complicated with infertility treated by laparoscopy combined with drug therapy in our hospital and the third affiliated hospital of Guangzhou Medical University were retrospectively analyzed. The fertility index of endometriosis (endometirosis fertility index,) was used. EFI) score was used to evaluate the effect of operation on postoperative pregnancy. Results EFI scores were 9 ~ 10 (high) in 39 cases, 5 ~ 8 (medium) in 35 cases, and 鈮，

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