摘要
目的探讨术前预测子宫内膜异位症生育指数(EFI)对于卵巢子宫内膜异位囊肿(OMA)合并不孕症患者的可行性,以指导临床优化术前病情评估及手术准备。方法纳入2020年1月至2024年9月于北京协和医院妇科内分泌病房由同一术者施行的宫腹腔镜联合手术治疗不孕症合并OMA的80例患者为研究对象,术前根据患者的病史、影像及肿瘤标志物等进行病灶和粘连的预测评分,进而与术后的EFI分项和总分值进行比较性分析。结果手术评分的术前预测值为(2.0±1.0),与术后实际分值(2.1±1.3)比较无显著性差异(P>0.05),且两者相关性P值<0.001。40%的病例预测评分与实际评分吻合,22.5%的病例预测评分大于实际评分,37.5%的病例预测评分小于实际评分。除粘连预测及其相关的美国生育学会(AFS)总分在手术前后有显著性差异外(P<0.05),其他分项均无显著性差异(P>0.05)。术前预测的EFI评分(5.3±1.6),与术后实际EFI评分(5.5±1.8)相比也无显著性差异(P>0.05),两者相关性P值<0.001。结论术前预测EFI评分是可行的,有助于筛选更有手术价值的病例,做好更充分的术前准备,也有利于提高患者对手术意义的认知。
Objectives:To evaluate the feasibility of preoperative prediction of endometriosis fertility index(EFI)for infertile patients with ovarian endometriomas(OMA),thereby guiding clinical optimization in preoperative condition assessment and surgical preparation.Methods:This study included 80 infertile cases complicated with OMA who underwent hysteroscopy and laparoscopy combined with surgery performed by the same surgeon in the endocrine ward of Peking Union Medical College Hospital between January 2020 and September 2024 were selected as the study subjectstreated by the same single surgeon.Preoperative prediction scores for lesions and adhesions were calculated based on medical history,imaging findings,and tumor markers.Furthermore,a comparative analysis was conducted among those scores of preoperative,postoperative sub items and total EFI scores.Results:The mean preoperative predictive score for surgical impact was(2.0±1.0),which did not significantly differ from the actual postoperative score of(2.1±1.3)(P>0.05)but showed a significant correlation(P<0.001).Of the cases,40%had matching predicted and actual scores,22.5%had overestimated predictions,and 37.5%had underestimated predictions.No other items(P>0.05)were statistically significant except for adhesion prediction and its associated American Fertility Society(AFS)total score,which showed a significant difference before and after surgery(P<0.05).The mean preoperative predicted EFI was(5.3±1.6)which did not significantly differ from the actual postoperative EFI of(5.5±1.8)(P>0.05)and also exhibited a significant correlation(P<0.001).Conclusions:Preoperative prediction scoring is feasible and can facilitate the identification of surgically valuable cases,enhance preoperative preparations,and improve patients’understanding of the value and the risk of surgery.
作者
任丽
洪新宇
邓姗
REN Li;HONG Xin-yu;DENG Shan(Department of Gynecology,Ziyang Central Hospital,Ziyang 641300;Department of Obstetrics&Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,National Clinical Research Center for Obstetric&Gynecologic Diseases,Beijing 100730)
出处
《生殖医学杂志》
2025年第12期1593-1599,共7页
Journal of Reproductive Medicine
基金
北京协和医院中央高水平医院临床科研专项(2022-PUMCH-C-065)。
