【摘要】 目的:探讨子宫内膜异位症生育指数预测促性腺激素释放激素激动剂治疗子宫内膜异位症的临床效果。方法:选择2011年1月至2013年6月我院收治的子宫内膜异位症合并不孕者232例(观察组112例、对照组120例),所有患者均实施腹腔镜手术治疗,对照组于术后月经来潮前5d采用GnRH-a行肌肉注射,观察组则结合EFI对使用GnRH-a治疗效果进行评估,调整GnRH-a治疗持续时间、剂量及是否联合雌孕激素治疗等,比较两组治疗后6个月时生殖相关激素水平、治疗过程中发生的不良反应、不同EFI评分累积妊娠率及妊娠方式。结果:治疗后,观察组E2和PRL水平均基本处于正常,且显著低于对照组(P<0.05),骨密度水平高于对照组(P<0.05),观察组发生潮热、生殖道干涩、闭经及骨质疏松的比例显著低于对照组(P<0.05),观察组0~4分、5~7分及8~10分各EFI评分累积妊娠率均显著高于对照组(P<0.05),观察组自然妊娠比例显著高于对照组(P<0.05),使用促排卵治疗后妊娠比例及人工受精妊娠比例均显著低于对照组(P<0.05)。结论:在使用GnRHa治疗时,对于EFI评分超过7分者,可在严格监测体内激素水平的同时继续GnRHa治疗;而针对EFI评分低于4分者,建议停止GnRHa治疗,早期人工辅助生殖措施。更多还原

【Abstract】 Objectives: To investigate the effect of endometriosis fertility index forecast gonadotropin- releasing with hormone agonist. Methods: 232 patients with merger endometriosis infertility from January 2011 to June 2013 in our hospital were choosed,and divided into the observation group( n = 112) and the control group( n= 120). All patients received laparoscopic surgery. The control group was given GnRH- a by intramuscular injection five days before menstruation,while the observation group received GnRH- a in combination with EFI,to evaluate the effect of GnR H- a. The duration,dosage and whether to combine estrogen and progesterone therapy was adjusted,to assess the reproductive hormone level 6 months after treatment,adverse reactions occurred,cumulative pregnancy rate and and pregnancy rates of different EFI modes. Results: After treatment,E2 and PRL level in the observation group were basically normal,significantly lower than control group( P < 0. 05); BMD in the observation group was higher than control group( P < 0. 05); the incidence of hot flashes,genital dryness,amenorrhea and osteoporosis in the observation group were significantly lower than control group( P < 0. 05). The cumulative pregnancy rate of those with EFI ratings of 0 to 4 points,5 to 7 minutes and 8 to 10 in observation group were higher than control group( P < 0. 05); the proportion of natural pregnancy in the observation group was higher than control group( P < 0. 05); after treatment for pregnancy using of ovulation and artificial insemination pregnancy proportion in the observation group was significantly lower than control group( P < 0. 05). Conclusion: For those with EFI score more than 7 points,GnRHa treatment can be continued with strict monitoring of hormone levels,while for those whose EFI score less than four points,GnRHa treatment should be stopped for early artificial assisted reproductive measures.更多还原