【摘要】：目的探討腹腔鏡手術聯(lián)合藥物治療對子宮內(nèi)膜異位癥(endometriosis,EMT)合并不孕患者生育力的影響。方法回顧分析我院和廣州醫(yī)科大學第三附屬醫(yī)院腹腔鏡手術聯(lián)合藥物治療且資料完整的110例EMT合并不孕的臨床資料,采用子宮內(nèi)膜異位癥生育指數(shù)(endometirosis fertility index,EFI)評分評估手術對術后妊娠的影響。結果 EFI評分9~10分(高)39例,5~8分(中)35例,≤4分(低)36例。術后3年自然妊娠率47.3%(52/110),應用克羅米芬組3年自然妊娠率為67.9%(35/53)明顯高于非克羅米芬組29.8%(17/57)(χ~2=14.449,P=0.000)。EFI評分單純腹膜型與腺肌病型比較差異有統(tǒng)計學意義(q=4.446,P0.05),內(nèi)囊型與腺肌病型比較差異有統(tǒng)計學意義(q=4.505,P0.05)。術后自然妊娠率單純腹膜型明顯高于腺肌病型(χ~2=6.549,P=0.010),內(nèi)囊型明顯高于腺肌病型(χ~2=6.144,P=0.013)。結論 EMT合并不孕患者在腹腔鏡手術時采用EFI評估生育力,以指導選擇個體化的后續(xù)治療方案;EFI評分低的患者不建議通過長期等待來提高妊娠率,克羅米芬的應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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