目的:探讨妊娠期急性脂肪肝(AFLP)的临床特点、诊断及治疗方法,以降低孕产妇和围产儿死亡率。方法:回顾性分析因妊娠期急性脂肪肝住院的26例患者临床表现、实验室检查、诊治情况和母婴结局。结果:26例病例中,早期出现厌食、乏力、恶心等症状21例,皮肤黄染19例,肝酶增高和凝血功能异常26例,胆红素升高21例,急性肾功能不全19例,弥漫性血管内凝血(DIC)16例,产后出血18例,肝性脑病6例,宫缩乏力5例;术中均尽早行Blynch缝合,无1例子宫切除;产妇死亡1例,死胎3例,新生儿轻度窒息4例,重度窒息1例,均抢救成功。结论:加强产检,重视孕妇妊娠晚期消化道症状和实验室检查异常,对AFLP尽早诊断、尽快终止妊娠、加强多学科的综合治疗可有效降低母婴死亡率。 Objective: To investigate the clinical features, diagnosis and treatment of acute fatty liver during pregnancy (AFLP) to reduce maternal and perinatal mortality. Methods: The clinical manifestations, laboratory tests, diagnosis and treatment of maternal and infant outcomes in 26 patients hospitalized with acute fatty liver during pregnancy were analyzed retrospectively. Results: In the 26 cases, there were 21 cases of anorexia, fatigue, nausea and other symptoms in the early stage, 19 cases of skin yellow staining, 26 cases of elevated liver enzymes and coagulation abnormalities, 21 cases of elevated bilirubin, 19 cases of acute renal insufficiency, 16 cases of diffuse intravascular coagulation (DIC), 18 cases of postpartum hemorrhage, 6 cases of hepatic encephalopathy and 5 cases of uterine inertia. All patients underwent Blynch suturing without hysterectomy as early as possible. There were 1 maternal death and 3 stillbirth , Mild neonatal asphyxia in 4 cases, 1 case of severe asphyxia were rescued successfully. Conclusions: Strengthening antenatal check-up, paying more attention to abnormal pregnancy and digestive tract symptoms and laboratory tests in pregnant women, early diagnosis of AFLP, termination of pregnancy as soon as possible, strengthening multidisciplinary comprehensive treatment can reduce maternal and infant mortality.