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目的探讨新生儿甲状腺功能亢进症(简称“甲亢”)病因、临床表现、诊断、治疗及预后。方法回顾性分析2005年7月至2011年7月我科诊断为新生儿甲亢的病例,分析患儿的病因、临床表现、治疗措施及效果。结果 12例新生儿甲亢中早产儿7例,足月儿5例,均有甲亢临床症状,其中1例出现甲亢危象。母亲均患有或曾经患甲亢。1例母亲在分娩前1天发现患有甲亢;7例母亲既往曾有甲亢病史,其中1例经规则治疗后甲状腺功能正常停药,但孕期未行甲状腺功能检查,3例孕前一直服药治疗,妊娠期停药,3例未规则治疗,妊娠期甲状腺功能异常;3例母亲妊娠5个月时诊断甲亢,一直服药治疗但症状未控制;1例母亲妊娠6个月时诊断甲亢,但未服药治疗。新生儿予以丙基硫氧嘧啶治疗后随访3个月至2岁,甲状腺功能均恢复正常。结论母亲患甲亢但不规则治疗是导致新生儿甲亢的重要原因。新生儿甲亢若能早期发现、及时治疗,可获得良好预后。
Objective To investigate the etiology, clinical manifestations, diagnosis, treatment and prognosis of neonatal hyperthyroidism (referred to as “hyperthyroidism”). Methods The cases diagnosed as neonatal hyperthyroidism from July 2005 to July 2011 were retrospectively analyzed. The etiology, clinical manifestations, treatment measures and effects of children were analyzed. Results Twelve cases of neonatal hyperthyroidism in preterm children in 7 cases, full-term children in 5 cases, have clinical symptoms of hyperthyroidism, including 1 case of hyperthyroidism crisis. Mothers have or have had hyperthyroidism. One of the mothers was found to have hyperthyroidism one day before delivery. Seven of the mothers had a history of hyperthyroidism in the past. Among them, one had normal thyroid function after regular treatment, but thyroid function tests were not performed during pregnancy, and three were given medication before pregnancy. 3 cases of abnormal thyroid function during pregnancy; 3 cases of mothers diagnosed hyperthyroidism at 5 months’ gestation and had been treated for medication but their symptoms were not controlled; one case of hyperthyroidism was diagnosed at 6 months of gestation, but no medication was given treatment. Neonates were treated with propylthiouracil after 3 months to 2 years of age, thyroid function returned to normal. Conclusion Mothers with hyperthyroidism but irregular treatment are the important causes of neonatal hyperthyroidism. If neonatal hyperthyroidism early detection, timely treatment, get a good prognosis.