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1、·40·中国现代医药杂志2008年6月第10卷第6期MMJC,Jun2008,Vol10,No.6妊娠合并甲状腺功能亢进症67例临床分析李传辉何皓左巧富邹文华【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
2、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。【关键词】妊娠甲状腺功能亢进症治疗P
3、regnancycombinedwithhyperthyroidism:analysisof67casesLiChuanhui,HeHao,ZuoQiaofu,etal.HengyangHospitalforWomanandChildren,Hengyang421001【Abstract】ObjectiveToevaluatetheclinicalcharacteristicsandtreatmentofhyperthyroidisminpregnancy.MethodsReviewedmedicalrecor
4、dsof67caseswithhyperthyroidismduringpregnancyatourhospitalandtheNanhuahospitalofNanhuauniversityoveraperiodof11years.67casesweredividedintotwogroupsaccordingtotheirtherapyrecords,onegrouphad37caseswithstandardtreatment,theotherhad30caseswithoutstandardtreatm
5、entascontrolgroup.Results%&Comparedwithstandardtherapygroup,theserumlevelsofFT4/FT3innon-standardtreatmentgroupweresignificantlyhigherandtheserumlevelsofTSHweresignificantlylower(P<0.01).’&Pregnantoutcome:themeannewbornweightandoneminuteApgarscoreafterdelive
6、ryincontrolgroupweresignificantlylowerthanthatofstandardtreatmentgroup(P<0.05).(&Deliveryway:Incontrolgroup,1casewasdeliveredwithforceps,9casesweredeliveredbycaesareansection.Instandardtreatmentgroup,19casesde-liveredthroughvagina,18casesweredeliveredbycaesa
7、rean-section.)&Complicationsincontrolgroup,10caseswereincorpo-ratedwithpregnancy-inducedhypertention(4casespre-eclampsia).6caseswithcardiacfailure,2caseswiththyrointoxication.Instandardtreatmentgroup,only1casewascomplicatedwithpreeclampsia.Conclusion%&Mildhy
8、perthyroidismpatientsduringpregnancyshouldbemanagedasnormaliftreatedproperlyandpromptly.’&Heartfailureandthyrointoxicationmustbeprevent-edinlaborandafterdelivery.(&Pregnancycombinedwithhyperthyr
