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目的探讨妊娠合并甲状腺功能亢进的临床治疗方法及效果。方法选取2012年5月至2017年5月收治于辽宁省沈阳市苏家屯区中心医院的70例妊娠合并甲状腺功能亢进患者作为研究对象,根据治疗方案不同将患者分为采用丙基硫氧嘧啶治疗的观察组(35例),与未经规范治疗或在治疗期间未经及时复查就自行停药的对照组(35例)。比较两组患者治疗后血清甲状腺激素水平、分娩方式、并发症以及妊娠结局等相关情况。结果观察组患者经治疗后游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)均显著低于对照组,促甲状腺激素(TSH)水平明显高于对照组,差异均有统计学意义(均P<0.05);观察组人工流产、早产、新生儿窒息、小于胎龄儿发生率均显著低于对照组,差异均有统计学意义(均P<0.05);观察组患者经阴道分娩率显著高于对照组,差异有统计学意义(P<0.05);观察组患者妊娠期高血压疾病、先兆子痫、心力衰竭、甲状腺功能亢进危象以及胎膜早破发生率均显著低于对照组,差异均有统计学意义(均P<0.05)。结论对妊娠合并甲状腺功能亢进患者采取规范化治疗,能够有效控制甲状腺激素水平,降低不良妊娠结局风险,利于母婴健康。
Objective To explore the clinical treatment of hyperthyroidism in pregnancy and its effects. Methods From May 2012 to May 2017, 70 pregnant women with hyperthyroidism undergoing pregnancy in Central Hospital of Sujiatun District, Shenyang City, Liaoning Province were selected as study subjects. Patients were divided into two groups according to different treatment regimen: propylthiouracil The treatment group (n = 35) and the control group (n = 35) who did not regularize their treatment or discontinued themselves without timely review during treatment. Serum thyroid hormone levels, mode of delivery, complications and pregnancy outcomes were compared between the two groups after treatment. Results After treatment, the free triiodothyronine (FT3) and free thyroxine (FT4) in the observation group were significantly lower than those in the control group, the level of thyroid stimulating hormone (TSH) was significantly higher than that of the control group, the difference was statistically significant (All P <0.05). The incidences of induced abortion, premature birth, neonatal asphyxia and small gestational age in the observation group were significantly lower than those in the control group (all P <0.05). In the observation group, vaginal delivery (P <0.05). The incidences of gestational hypertension, preeclampsia, heart failure, hyperthyroidism and premature rupture of membranes in the observation group were significantly lower than those in the control group Control group, the differences were statistically significant (P <0.05). Conclusions The standardized treatment of hyperthyroidism in pregnancy combined with standardized treatment can effectively control thyroid hormone levels, reduce the risk of adverse pregnancy outcomes, which will benefit the health of mothers and infants.