Objective To evaluate the efficacy and safety of hysteroscopic management of early endogenous cesarean scar pregnancy (CSP) after cesarean section .Methods A retrospective analysis was performed on 51 pa‐tients of endogenous cesarean scar pregnancy (CSP) in Cang Zhou City Central Hospital from July 2010 to October 2015 . They were divided into three groups according to different treatment ,group A ( hysteroscopic resection ,n=21) , group B ( methotrexate therapy combined with curettage ,n=17) and group C ( bilateral uterine artery embolism combined with curettage ,n = 13). The clinical efficacy of three groups was analyzed .Results Twenty patients were cured in group A .Seventeen patients were treated by methotrexate therapy combined with curettage ,11 of whom were cured in group B .Thirteen patients were treated by bilateral uterine artery embolism combined with curettage ,9 of whom were cured .The cure rate of treatment in group A was significantly higher than that in oth‐er groups ,and there was statistically significant difference ( P <0 .05) .The difference in time for serumβ‐human chorionic gonadotropin (β‐hCG) level decreasing to normal and postoperative hospital stay between group A and group B was statistically significant ( P <0 .05) .The difference in time for postoperative hospital stay between group A and group C was statistically significant ( P<0 .05) .While the difference in time for serum(β‐hCG) level decreasing to normal between group A and group C was not statistically significant ( P > 0 .05) .Conclusion Method of hysteroscopic resection is superior to methotrexate therapy combined with curettage and bilateral uter‐ine artery embolism combined with curettage .It is also an effective and safe therapy for early endogenous pregnan‐cy of cesarean section scar .%目的：探讨宫腔镜手术治疗早期内生型剖宫产术后子宫瘢痕妊娠（CSP）的安全性及可行性。方法回顾性分析2010年7月至2015年10月在沧州市中心医院治疗的51例早期内生型CSP患者的临床资料，按照治疗方法的不同划分组别：宫腔镜组21例，行宫腔镜病灶切除术；甲氨蝶呤（MTX）＋清宫组17例，甲氨蝶呤治疗后行B超导视下清宫术；双侧子宫动脉栓塞＋清宫组13例，行双侧子宫动脉栓塞＋B超导视下清宫术。比较3组患者的治疗结局。结果①治疗方式：宫腔镜组21例，1例术中因病灶组织坏死发生喷射状出血，行开腹手术切除病灶，其余20例治疗成功；甲氨蝶呤＋清宫组17例，给予甲氨蝶呤后，在B超监视下行清宫术，4例因术中出血过多行腹腔镜病灶切除术，2例因阴道出血多提前行清宫术，清宫失败行开腹手术切除病灶，17例治疗成功11例；栓塞＋清宫组13例在子宫动脉栓塞后行超声引导下的清宫术，4例清宫术失败，2例改行开腹病灶切除术，2例改行腹腔镜病灶切除术，13例成功治疗9例。②住院时间及血清β‐人绒毛膜促性腺激素（β‐hCG）降至正常时间：宫腔镜组术后住院时间（5．6±1．2）d，血清β‐hCG降至正常时间（24±4）d；甲氨蝶呤＋清宫组术后住院时间（14．5±3．3）d，血清β‐hCG降至正常时间（32±4）d；栓塞＋清宫组术后住院时间（7．4±1．8）d，血清β‐hCG降至正常时间（22．9±1．7）d。宫腔镜组与甲氨蝶呤＋清宫组2组术后住院时间及血清β‐hCG降至正常时间比较，差异均有统计学意义（P＜0．05），宫腔镜组与栓塞＋清宫组术中术后住院时间相比差异有统计学意义（P＜0．05），而与血清β‐hCG转为正常的时间比较，差异无统计学意义（P＞0.05），甲氨蝶呤＋清宫组与栓塞＋清宫组2组术后住院时间及血清β‐hCG降至正常时间比较，差异均有统计学意义（P＜0．05）。③治疗成功率：宫腔镜组、栓塞＋清宫组与甲氨蝶呤＋清宫组进行两两比较，宫腔镜组分别与之相比，其治疗成功率明显高于其他2组，差异均有统计学意义（P＜0．05）。结论宫腔镜CSP病灶切除术是治疗CSP的有效措施，疗效确切、住院时间短、恢复快。
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