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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:回顾性分析该院8年间妊娠合并甲状腺功能亢进28例患者的资料,按照正规治疗与否分为对照组18例和治疗组10例。结果:①两组患者甲状腺水平差异有显著性(P<0.01)。②妊娠结局:两组新生儿体重、1 min Apgar评分差异有显著性(P<0.05),治疗组人工流产1例,对照组人工流产及自然流产6例,差异有显著性(P<0.05)。③妊娠并发症:对照组中7例患者合并妊娠期高血压疾病(其中子痫前期4例),2例患者合并心功能不全,1例发生甲状腺危象。而治疗组中仅1例合并子痫前期。④分娩方式:治疗组中阴道分娩5例,剖宫产4例,对照组经阴道分娩1例,阴道助产2例,剖宫产9例。结论:①孕期病情控制良好的患者可视为正常妊娠,但仍需严密监测。②轻度妊娠合并甲状腺功能亢进和病情控制良好的患者可阴道试产,中、重度患者适当放宽剖宫产指征。③产时及产后防止心功能不全和甲状腺危象。④确诊的患者应该及时给予治疗且治疗应规范。
Objective: To investigate the clinical features and treatment principles of hyperthyroidism during pregnancy. Methods: The data of 28 patients with pregnancy complicated with hyperthyroidism during 8 years in our hospital were retrospectively analyzed. According to the regular treatment, 18 cases were divided into control group and 10 cases in treatment group. Results: ① There was significant difference in thyroid level between the two groups (P <0.01). (2) The pregnancy outcome: There was a significant difference in body weight among two groups (P <0.05) at 1 minute, 1 case of induced abortion in treatment group and 6 cases of induced abortion and spontaneous abortion in control group (P <0.05) . ③ Pregnancy complications: In the control group, 7 cases were complicated with gestational hypertension (4 cases of preeclampsia), 2 cases had cardiac insufficiency, and 1 case had thyroid crisis. In the treatment group, only 1 patient had preeclampsia. ④ mode of delivery: the treatment group, 5 cases of vaginal delivery, cesarean section in 4 cases, the control group by vaginal delivery in 1 case, vaginal delivery in 2 cases, 9 cases of cesarean section. Conclusion: (1) Patients with well-controlled pregnancy may be regarded as normal pregnancy, but still need to be closely monitored. ② mild pregnancy with hyperthyroidism and well-controlled patients with vaginal trial production, moderate and severe patients appropriate relaxation of cesarean indications. ③ during and postpartum to prevent cardiac dysfunction and thyroid crisis. ④ diagnosed patients should be timely treatment and treatment should be standardized.