[1]黄俊花,刘明星①**,陈晓红②,等.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[J].中国微创外科杂志,2017,17(07):594-598.
　Huang Junhua*,Liu Mingxing,Chen Xiaohong,et al.On Fertility of Different Pathological Types of Endometriosis Combined with Infertility[J].Chinese Journal of Minimally Invasive Surgery,2017,17(07):594-598.
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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()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年07期
页码:
594-598
栏目:
临床论著
出版日期:
2017-07-20

文章信息/Info

Title:
On Fertility of Different Pathological Types of Endometriosis Combined with Infertility
作者:
黄俊花; 刘明星①**; 陈晓红②; 陈曼
汕头大学医学院第一附属医院生殖医学科，汕头515041
Author(s):
Huang Junhua*;  Liu Mingxing;  Chen Xiaohong;  et al.
*First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
关键词:
腹腔镜; 子宫内膜异位症; 不孕; 生育力; 生育指数
Keywords:
Laparoscope; Endometriosis; Infertility; Fertility; Fertility index
文献标志码:
A
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） (χ2=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，P<005)，内囊型与腺肌病型比较差异有统计学意义(q=4.505，P<0.05)。术后自然妊娠率单纯腹膜型明显高于腺肌病型 (χ2=6.549，P=0.010)，内囊型明显高于腺肌病型 (χ2=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:
ObjectiveTo discuss the fertility effects of combination of laparoscopic operations and pharmacotherapy on endometriosis (EMT) patients with infertility.MethodsA retrospective analysis was applied to assess the influence on the pregnancy rates in 110 infertile and endometriotic patients after laparoscopic surgery by using the endometriosis fertility index (EFI) in our hospital and the Third Affiliated Hospital of Guangzhou Medical University. ResultsThe EFI scores were 9-１0 (high) in 39 cases, 5-8 (medium) in 35 cases, less than or equal to 4 points (low) in 36 cases, respectively. The total spontaneous pregnancy rate was 47.3% (52/110) at 3 years after laparoscopic operation. The total spontaneous pregnancy rate of the clomiphene stimulate ovulation group (67.9%, 35/53) was significantly higher than that of the non-stimulate ovulation group (29.8%, 17/57). The difference was statistically significant (χ2=14.449, P=0.000). Difference of the EFI between peritoneal type and adenomyosis after surgery was statistically significant (q=4.446, P<0.05). This statistically significant difference also existed in intracapsular type and adenomyosis (q=4.505, P<0.05). The spontaneous pregnancy rate in peritoneal type after surgery was higher than the adenomyosis in EMT patients with infertility. The difference was statistically significant (χ2=6549, P=0.010). This statistically significant difference also existed in intracapsular type and adenomyosis (χ2=6.144, P=0013).ConclusionsFertility status after laparoscopic surgeries could be assessed by EFI in EMT patients with infertility, in order to make a choice of an individualized follow-up treatment. It is not recommended to improve pregnancy rate waiting for a long time in patients with low EFI scores. Clomiphene application can improve the spontaneous pregnancy rate in patients with infertile EMT.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：2015年广东省医学科研基金指令性课题项目（项目编号：C2015036）**通讯作者，E-mail：13922255263@139.com①（广州医科大学附属第三医院妇产科， 广州510150）②(汕头大学医学院第一附属医院妇产科，汕头515041)
更新日期/Last Update: 2017-09-21