摘要
目的探讨妊娠合并甲状腺功能亢进的临床特点及处理原则。方法回顾性分析妊娠合并甲状腺功能亢进67例患者的资料,按照正规治疗与否分为对照组30例和治疗组37例。结果①治疗组患者甲状腺激素水平与对照组比较差异统计学上有意义(P<0.05);②妊娠结局:两组新生儿平均体重、1分钟Apgar评分比较,差异统计学上有意义(P<0.05);③分娩方式:治疗组患者阴道分娩19例,剖宫产18例;对照组患者经阴道产钳助娩1例,剖宫产19例,阴道分娩10例;④并发症:对照组中10例患者合并妊娠期高血压疾病(其中子痫前期4例),6例患者合并心功能不全,2例患者发生甲状腺危象。治疗组中1例患者同时合并子痫前期。结论①孕期病情得到控制的患者可视同正常妊娠;②产时及产后防止心功能不全和甲状腺危象;③中、重度妊娠合并甲状腺功能亢进症适当放宽剖宫产指征。妊娠合并甲状腺功能亢进症常危及母婴健康,为降低母儿风险,孕前需很好地控制病情,孕期密切监控,合理治疗。
Objective To evaluate the clinical characteristics and treatment of hyperthyroidism in pregnancy.Methods Reviewed medical records of 67 cases with hyperthyroidism during pregnancy at our hospital and the Nanhua hospital of Nanhua university over a period of 11 years.67 cases were divided into two groups according to their therapy records, one group had 37 cases with standard treatment, the other had 30 cases without standard treatment as control group. Results ①Compared with standard therapy group, the serum levels of FT2/FT3 in non-standard treatment group were significantly higher and the serum levels of TSH were significantly lower（P〈0.01）.②Pregnant outcome： the mean newborn weight and one minute Apgar score after delivery in control group were significantly lower than that of standard treatment group （P〈0.05）. ③Delivery way： In control group, 1 case was delivered with force ps, 9 cases were delivered by caesarean section.In standard treatment group, 19 cases delivered through vagina,18 cases were delivered by caesarean-section. ④Complications in control group,10 cases were incorporated with pregnancy-induced hypertention （4 cases pre-eclampsia）.6 cases with cardiac failure, 2 cases with thyrointoxication.In standard treatment group, only 1 case was complicated with preeclampsia. Conclusion ①Mild hyperthyroidism patients during pregnancy should be managed as normal if treated properly and promptly. ②Heart failure and thyrointoxication must be prevented in labor and after delivery. ③Pregnancy combined with hyperthyroidism often endangers maternal and neonatal health. Therefore, for reducing the risks, before pregnancy, the patients＇conditions should be well controlled; during pregnancy, gravida should be closely paid more attention to and treated reasonably rational.
出处
《中国现代医药杂志》
2008年第6期40-43,共4页
Modern Medicine Journal of China
