Objective: To analyze the therapeutic effect and safety of the uterine artery infusion embolism (UAIE) combined with curettage in the treatment of cesarean scar pregnancy (CSP). Methods:A total of 61 CSPⅡpatients who underwent UAIE combined with curettage within 48 hours were retrospectively analyzed, from March 2010 to October 2015, in our hospital. The indexes such as operative time, intraoperative blood loss,postoperative incidence of adverse reactions and postoperative human chorionic gonadotropin (β-hCG) level were recorded. Results: ①All patients were punctured and intervented successfully. There were 32 cases with abdominal pain, 5 cases with fever and 7 cases with hip pain. ②In those 61 cases, the effective rate of intervention treatment was 91.8% (56 cases were cured and 5 cases failed). Three cases had massive vaginal bleeding in their curettage,in which one case was converted to laparotomy. The intervention treatment failed in 1 case who occured massive vaginal bleeding after 28 days of intervention and 3 cases with persistent ectopic pregnancy. ③The average hospitalization expenses were (9 235 ±325) RMB; ④Those cases were divided into 4 groups according to the decline level of β-hCG after intervention treatment. All of 20 patients with the decreased level of β-hCG more than 75%were cured (Group 1). In those 29 cases with the decreased level ofβ-hCG within 50%-75%(Group 2), 3 cases had persistent ectopic pregnancy, and 1 cases whose β-hCG level was up to 236 064 IU/L before treatment was failed. In 10 cases with the decreased level of β-hCG within 25%-50% (Group 3), 4 cases had persistent ectopic pregnancy, and 2 cases were failed;only 1 case with the decreased level of β-hCG less than 25%(Group 4) was converted to operation. Conclusions: The UAIE combined with curettage in the treatment of CSP is safe and effective. The decreased level of β-hCG after intervention treatment can be used as one of parameters to predict the prognosis. The greater the declined level of β-hCG, the better the prognosis. Those patients with a small decreased level of β-hCG were more likely to have persistent ectopic pregnancy, which suggested that they should be monitored after intervention treatment.%目的：探讨子宫动脉灌注甲氨蝶呤（MTX）栓塞联合清宫术治疗剖宫产瘢痕妊娠（CSP）的效果与安全性。方法：选取2010年3月—2015年10月我院妇产科诊治的CSPⅡ型患者61例，采用经子宫动脉栓塞灌注MTX，灌注之后48 h内在B型超声（B超）引导下行清宫术，观察手术时间、术中出血量、手术后不良反应并监测血人绒毛膜促性腺激素β亚单位（β-hCG）变化情况，分析治疗效果与安全性。结果：①所有患者均1次穿刺成功、造影，介入后出现中下腹疼痛32例，发热5例，臀部疼痛7例；②61例患者中治愈56例，失败5例，治疗有效率91.8%。3例清宫术中阴道大出血，其中1例转开腹手术。1例患者治疗后28 d阴道大出血，3例术后出现持续性异位妊娠，治疗失败；③所有患者平均住院费用为（9235±325）元；④根据治疗前后血β-hCG下降幅度将60例患者分为4组。血β-hCG下降≥75%的20例患者均痊愈；下降在50%～75%有29例，其中3例持续性异位妊娠，1例治疗失败，其术前血β-hCG达236064 IU/L；血β-hCG下降在25%～50%有10例，其中4例出现持续性异位妊娠，有2例治疗失败；血β-hCG下降＜25%仅1例，治疗失败改开腹手术。结论：采用子宫动脉灌注MTX栓塞联合清宫治疗CSP，治疗有效率及安全性较高。根据治疗前后患者血β-hCG下降水平可以推断患者预后，血β-hCG下降幅度越大预后越好。血β-hCG下降幅度小的患者有持续性异位妊娠可能，需要加强治疗后的监测。
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