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目的观察腹腔镜手术联合孕三烯酮治疗子宫内膜异位症合并不孕的疗效及不同评分系统对妊娠结局的预测价值。方法回顾性分析2004年1月-2006年12月收治的97例子宫内膜异位症合并不孕患者的临床病理资料,统计其术后妊娠率及活产率。结果术后1年内与1～2年的妊娠率与活产率比较,差异均无统计学意义(P>0.05)。根据美国生育协会1985年修订的子宫内膜异位症分期标准(r-AFS)进行分期,各期患者术后妊娠率差异无统计学意义(P>0.05);但随着分期升高,活产率逐渐下降(P<0.05)。子宫内膜异位症生育指数(EFI)评分越高,其妊娠率和活产率也越高(P<0.05)。结论子宫内膜异位症患者腹腔镜手术后联用孕三烯酮可能会提高远期妊娠率。r-AFS分期对妊娠结局的预测有一定局限性,而EFI具有较好的预测性。
Objective To observe the efficacy of laparoscopic surgery combined with gestrinone in the treatment of endometriosis complicated with infertility and the predictive value of different scoring systems for pregnancy outcome. Methods The clinical and pathological data of 97 cases of endometriosis complicated with infertility who were treated from January 2004 to December 2006 were retrospectively analyzed. The postoperative pregnancy rate and live birth rate were calculated. Results There was no significant difference in pregnancy rate and live birth rate between one year and two years after operation (P> 0.05). According to the American Society of Reproductive Aid, the endometrial staging (r-AFS) revised in 1985, there was no significant difference in postoperative pregnancy rate between the two groups (P> 0.05); however, with the increase of staging The yield decreased gradually (P <0.05). The higher the endometriosis fertility index (EFI) score, the higher the pregnancy rate and live birth rate (P <0.05). Conclusions Patients with endometriosis combined with gestrinone after laparoscopic surgery may improve the long-term pregnancy rate. The prediction of pregnancy outcome by r-AFS staging has some limitations, while EFI has better predictive value.