关键词: 剖宫产瘢痕部位妊娠, 宫腔镜病灶切除术, 超声监测下吸宫术

Abstract: Objective To compare the efficacy between hysteroscopic resection surgery and ultrasound-guided uterine aspiration in the treatment of cesarean scar pregnancy（CSP）．Methods A retrospective analysis was performed in 129 patients diagnosed with CSP（type I or Ⅱ）and treated in Nanning Maternal and Child Health Hospital from July 2021 to October 2023．Their duration of amenorrhea was between 38~83 d,with a median of 48 days．Among them,42 patients were treated with hysteroscopic resection surgery therapy（group A）,87 patients were treated with ultrasound-guided uterine aspiration therapy and（group B）．Then,the levels of human chorionic gonadotropin（HCG）,the amount of the intraoperative bleeding volume,surgical time,hospitalization time,and hospitalization expenses were compared between the two groups at one,three,seven and 14 days postoperativey．Results After one day of surgery,the serum HCG levels of two groups significantly decreased,with a decrease of more than 50%,and the magnitude and rate of decrease in serum HCG levels of group A were significantly larger than those of group B（P<0.05）;After three,seven,and 14 day of surgery,serum HCG levels continued to decrease．Furthermore,the intraoperative bleeding volume,surgical time,hospitalization time,hospitalization expenses in group A were（15.35±14.53）mL,（60.73±53.05）min,（4.33±1.90）d,（6 689.23±2 216.19）yuan,respectively．That in group B were（26.09±29.24）mL,（51.59±54.46）min,（4.82±1.83）d,（6 270.34±2 547.85）yuan,respectively．Compared to group B,the intraoperative bleeding volume of group A was significantly lower（P<0.05）,and the hospitalization time is shorter,while there was no significant difference in surgical time and hospitalization expenses．Conclusions Both of hysteroscopic resection surgery and ultrasound-guided uterine aspiration can treat cesarean scar pregnancy effectively,but the former is superior to the latter in terms of the magnitude and rate of decrease in serum HCG levels after surgery,intraoperative bleeding volume,and hospitalization time,with no significant increase in surgical time and hospitalization expenses．

Key words: cesarean scar pregnancy, hysteroscopic resection surgery, ultrasound-guided uterine aspiration