宫腔镜治疗有症状剖宫产切口憩室103例分析

目的：探讨宫腔镜治疗有症状的剖宫产切口憩室的临床疗效。方法：回顾性分析 2011年 1 月-2017年11月在首都医科大学附属复兴医院宫腔镜诊治中心行宫腔镜手术治疗的103例有症状的剖宫产切口憩室患者的临床资料，随访记录经期间出血改善情况与生育结局。结果：103例患者平均手术时间为（11.0±3.3）min，平均住院时间为（3.9±1.0）d，平均住院费用为（6 217±556）元，无手术并发症发生。症状改善情况的随访时间为术后3个月，经宫腔镜手术治疗后经期间出血改善明显，改善率为82.5%（85/103）；手术前后的出血持续时间分别是（13.83±3.41）d和（7.43±2.29）d，差异有统计学意义（t=3.108，P=0.021）。随访妊娠结局时间为术后4～82个月，17例继发不孕患者中，术后14例成功妊娠。结论：宫腔镜手术治疗有症状的剖宫产切口憩室，术后经期间出血症状和妊娠结局明显改善，是一种安全、有效、经济的治疗方法。

103 Cases of Hysteroscopic Surgery for Symptomatic Cesarean Scar Defect

Objective：To investigate the clinical effect of hysteroscopic surgery in the treatment of symptomatic cesarean scar defect. Methods：The clinical data were retrospectively analyzed for the 103 patients with symptomatic cesarean scar defect who underwent hysteroscopic surgery from January 2011 to November 2017 in Hysteroscopy Center, Fuxing Hospital Affiliated to Captial Medical University. The symptom improvement and pregnant outcomes were followed-up. Results：In total 103 patients, the average operation time was (11.0±3.3) min, the average days of hospital stay was (3.9±1.0) d, the average hospitalization cost was (6 217±556) yuan, and no complications occurred. The symptom improvement was followed-up after three months of surgery. The clinical symptoms of intermenstrual bleeding were significantly improved after hysteroscopic surgery with an improvement rate of 82.5% (85/103). Mean duration of bleeding prior and after the treatment were (13.83±3.41) d and (7.43±2.29) d respectively, and the differences were statistically significant (t=3.108, P=0.021). The pregnant outcomes were followed-up for 4-82 months after the initial surgery. For the 17 cases of secondary infertility patients, 14 cases got successful pregnancy. Conclusions：Hysteroscopic surgery can significantly improve postoperative symptoms of intermenstrual bleeding and pregnant outcome with symptomatic cesarean scar defect and is a safe, effective, and economical treatment.