目的:分析剖宫产瘢痕部位妊娠（CSP）超声监测下清宫手术治疗失败的相关因素，为其治疗提供更明确的证据，指导临床实践。方法:回顾性分析内蒙古自治区人民医院2015年7月至2018年7月收治的剖宫产瘢痕妊娠患者84例，排除治疗前子宫动脉栓塞介入病例，共纳入彩超监测下清宫术30例为观察对象，按治疗成功与失败分为两组，对治疗失败病例进一步统计分析。结果:纳入30例剖宫产瘢痕部位妊娠，彩超监测下清宫术，9例失败，失败率30%。孕囊距肌层厚度、孕囊宽径、治疗前绒毛膜促性腺激素（HCG）高值与治疗失败有关，瘢痕类型中治疗成功者以Ⅰ型为主，占83.3%，Ⅱ型治疗成功与失败各占50%，差异无统计学意义（n P>0.05）；ROC曲线分析结果显示：孕囊距肌层厚度、孕囊宽、治疗前血HCG高值对于预测彩超监测病灶清除术失败的截断值分别为≤2.5 mm、>23 mm，血HCG≤50 200 mIU/mL。n 结论:孕囊距肌层厚度>2.5 mm、孕囊宽≤23 mm、血HCG≤50 200 mIU/mL为彩超监测下清宫术治疗成功的截断值，可为剖宫产瘢痕部位妊娠（GSP）超声监测下清宫手术治疗提供依据。“,”Objective:To analyze the factors related to the failure in the management of cesarean scar pregnancy using ultrasound-guided curettage, so as to provide definite evidence for clinical treatment.Methods:A total of 84 patients with cesarean scar pregnancy who received treatment in Inner Mongolia People's Hospital from July 2015 to July 2018 were retrospectively analyzed. After excluding patients with uterine artery embolization before treatment, 30 patients who underwent ultrasound-guided curettage were divided into a successful treatment group and a failed treatment group. The factors of failure in ultrasound-guided curettage were analyzed.Results:Nine (30%) out of 30 patients with cesarean scar pregnancy failed in ultrasound-guided curettage. The interval between gestational sac and muscle layer, the width of gestational sac and high human chorionic gonadotropin value were related to the failure of ultrasound-guided curettage. Among different types of cesarean scar pregnancy, ultrasound-guided curettage was the most successful in patients with type I cesarean scar pregnancy, accounting for 83.3%. There was no significant difference in the proportion of type II cesarean scar pregnancy patients who succeeded versus those failed in ultrasound-guided curettage (n P > 0.05). Receive operator characteristic curve revealed that the cut-off values of interval between gestational sac and muscle layer, the width of gestational sac and high human chorionic gonadotropin value for identifying patients at risk for failure in ultrasound-guided curettage was ≤ 2.5 mm, > 23 mm and ≤ 50 200 mIU/mL, respectively..n Conclusion:The interval between gestational sac and muscle layer > 2.5 mm, the width of gestational sac ≤ 23 mm and high human chorionic gonadotropin value ≤ 50 200 mIU/mL are the cut-off values of successful ultrasound-guided curettage, which can provide the basis for ultrasound-guided curettage in the management of cesarean scar pregnancy.