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柯兴氏综合征合并妊娠时,孕产妇及围产病率和死亡率均很高,手术和药物治疗除可能减少早产率外,不能改善妊娠结局。有建议对本病作如下处理:①妊娠早期时应行垂体探查术,切除可能存在的垂体腺瘤。如考虑病因在肾上腺,应行肾上腺探查术,切除肾上腺良性肿瘤并除外癌肿。②妊娠晚期时尽早娩出胎儿,产后再决定手术或药物治疗。本病经阴道产优于剖宫产。当无明显累及孕产妇和胎儿时,可考虑用甲吡酮延缓分娩至胎儿成熟。③妊娠中期时处理较灵活。治疗方案应个体化。可采用手术,亦可先用药物缓解肾上腺皮质功能亢进。因未治疗者孕产妇和围产结局预后均差,所以不宜单独采用支持疗法。
Cushing’s syndrome combined with pregnancy, maternal and perinatal morbidity and mortality were high, surgery and drug therapy in addition to reducing preterm birth rate may not improve pregnancy outcomes. Proposed treatment of the disease as follows: ① early pregnancy should be pituitary exploration, removal of possible pituitary adenoma. If you consider the cause of the adrenal gland, should be adrenal exploration, removal of benign and adrenal tumors except cancer. ② late pregnancy as soon as possible to deliver the fetus, postpartum and then decide surgery or drug treatment. Vaginal delivery of this disease is superior to cesarean section. When no significant involvement of pregnant women and fetuses, may consider using methamphetamine delay childbirth to fetal maturity. The third trimester treatment more flexible. Treatment should be individualized. Surgery can be used, can also be used to ease the drug adrenal cortex hyperthyroidism. Because untreated maternal and perinatal outcomes are poor prognosis, it should not be used alone to support therapies.