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目的:探讨超声引导下经皮经肝胆囊穿刺引流术（PTGBD）治疗妊娠合并急性胆源性胰腺炎（ABP）的临床价值和安全性。方法:回顾性分析2010—2019年中国医科大学附属盛京医院收治的47例妊娠合并ABP患者的临床资料。其中，采用保守治疗19例（保守组），采用PTGBD治疗28例（PTGBD组）。分别于治疗前和治疗后3 d行急性生理学和慢性健康状况评分Ⅱ（APACHE Ⅱ）评估，并检测血淀粉酶、白细胞和总胆红素，记录治疗结果。结果:两组治疗前比较差异无统计学意义（n P>0.05）；两组治疗后APACHE Ⅱ、血淀粉酶、白细胞、总胆红素均明显低于治疗前[保守组：（5.9 ± 1.9）分比（7.2 ± 1.3）分、（736.8 ± 64.2）U/L比（969.2 ± 124.3）U/L、（10.3 ± 1.4）× 10n 9/L比（14.7 ± 2.1）× 10n 9/L和（55.3 ± 9.5）mmol/L比（67.1 ± 10.2）mmol/L；PTGBD组：（4.1 ± 1.7）分比（7.0 ± 1.2）分、（465.5 ± 77.9）U/L比（1 001.8 ± 112.5）U/L、（8.4 ± 2.2）× 10n 9/L比（13.5 ± 2.6）× 10n 9/L和（38.4 ± 10.6）mmol/L比（73.7 ± 12.5）mmol/L]，且PTGBD组各指标明显低于保守组，差异有统计学意义（n P<0.05）。保守组经过治疗，5例病情恶化母婴死亡，1例胎儿出生后死亡。PTGBD组3例病情恶化母婴死亡，1例胎儿出生后死亡。PTGBD组孕妇治愈率和胎儿存活率均明显高于保守组[89.3%（25/28）比14/19和85.7%（24/28）比13/19]，差异有统计学意义（n P0.05). The APACHE Ⅱ, serum amylase, white blood cell and total bilirubin after treatment were significantly lower compared with those before treatment, conservative group: (5.9 ± 1.9) scores vs. (7.2 ± 1.3) scores, (736.8 ± 64.2) U/L vs. (969.2 ± 124.3) U/L, (10.3 ± 1.4) × 10n 9/L vs. (14.7 ± 2.1) × 10n 9/L and (55.3 ± 9.5) mmol/L vs. (67.1 ± 10.2) mmol/L; PTGBD group: (4.1 ± 1.7) scores vs. (7.0 ± 1.2) scores, (465.5 ± 77.9) U/L vs. (1 001.8 ± 112.5) U/L, (8.4 ± 2.2) × 10n 9/L vs. (13.5 ± 2.6) × 10n 9/L and (38.4 ± 10.6) mmol/L vs. (73.7 ± 12.5) mmol/L, and the indexes in PTGBD group were statistically lower than those in conservative group, and there were statistical differences (n P<0.05). In conservative group, 5 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. In PTGBD group, 3 cases died (both mother and infant) after deterioration of the condition and 1 infant died after birth. The maternal cure rate and fetal survival rate in PTGBD group were statistically higher than those in conservative group PTGBD: 89.3% (25/28) vs. 14/19 and 85.7% (24/28) vs. 13/19, and there were statistical differences (n P<0.05).n Conclusions:Among patients with pregnancy combined with ABP, early PTGBD is more effective than conservative medication, and quickly relieves symptoms and reduces complications.