摘要
目的探讨妊娠期合并甲减或亚临床甲减经激素替代疗法的应用价值。方法选取深圳市南山区蛇口人民医院2018年1月~2019年11月收治的117例妊娠期合并甲减及亚临床甲减患者,按照住院先后顺序分为对照组(53例)与观察组(64例)。对照组采用常规治疗,观察组采用激素替代治疗。比较两组治疗前后甲状腺功能、并发症发生率、产后出血以及妊娠结局等情况。结果治疗6周后观察组患者促甲状腺激素、血清游离甲状腺素、血清游离三碘甲腺原氨酸指标低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率与对照组比较,差异无统计学意义(P>0.05);观察组患者产后2、24 h出血量少于对照组(P<0.05);观察组分娩孕龄长于对照组,开奶率、新生儿体重、新生儿Apgar评分、脐动脉血气pH值高于对照组,差异有统计学意义(P<0.05)。结论对妊娠期合并甲减或亚临床甲减患者实施药物治疗,在改善血脂水平、提高甲状腺功能、提升妊娠结局方面有一定优势。建议以常规治疗为基础,而后联合开展激素替代治疗。
Objective To explore and analyze the application value of hormone replacement therapy in pregnancy with hypothyroidism or subclinical hypothyroidism.Methods A total of 117 pregnant women with hypothyroidism and subclinical hypothyroidism in Nanshan Shekou People′s Hospital of Shenzhen from January 2018 to November 2019 were selected and divided into control group(53 cases)and observation group(64 cases)according to the order of hospitalization.The control group was treated with conventional treatment,and the observation group was treated with hormone replacement therapy.Thyroid function,incidence of complications,postpartum hemorrhage and pregnancy outcome were compared between the two groups before and after treatment.Results After 6 weeks of treatment,the thyroid stimulating hormone,serum free thyroxine and serum free triiodothyronine in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was not statistically significant compared with that in the control group(P>0.05).The bleeding of 2 h postpartum and 24 h postpartum in the observation group was less than that in the control group,the differences were statistically significant(P<0.05).The gestational week of delivery in the observation group was longer than that in the control group,and the milk opening rate,neonatal weight,Apgar score and pH value of umbilical artery blood gas in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The drug treatment for pregnant women with hypothyroidism or subclinical hypothyroidism should be based on conventional treatment,and then combined with hormone replacement therapy;it has significant advantages in improving blood lipid level,improving thyroid function and improving pregnancy outcome.
作者
吴燕华
周静
曾丽娜
WU Yan-hua;ZHOU Jing;ZENG Li-na(Department of Obstetrics,Nanshan Shekou People′s Hospital of Shenzhen,Guangdong Province,Shenzhen518067,China)
出处
《中国当代医药》
CAS
2021年第3期145-147,共3页
China Modern Medicine
关键词
妊娠期合并甲减
亚临床甲减
激素替代治疗
血脂
妊娠结局
Hypothyroidism in pregnancy
Subclinical hypothyroidism
Hormone replacement therapy
Blood lipid
Pregnancy outcome
