妊娠期亚临床甲状腺功能减退干预对妊娠结局的影响分析
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摘要
目的分析临床干预后妊娠期亚临床甲状腺功能减退的妊娠结局。方法选择2016年6月至2018年6月在成都天府新区人民医院妇产科门诊确诊的妊娠期亚临床甲状腺功能减退症孕妇按照是否接受左甲状腺素钠片治疗分为观察组142和对照组56例,同时选取50例健康孕妇作为健康组,观察3组的甲状腺功能、胎儿双顶径、妊娠并发症和妊娠结局。结果对照组流产、妊娠期糖尿病、贫血、早产、低出生体重儿和胎儿宫内窘迫的发生率均明显高于观察组和健康组,差异有统计学意义(P均<0.05),而观察组和健康组之间无明显统计学差异(P均>0.05)。经两两比较,胎儿死亡发生率3组之间无明显统计学差异(P>0.05)。37w时对照组孕妇TSH水平明显高于观察组和健康组,胎儿双顶径明显小于观察组和健康组,差异有统计学差异(P<0.05);而观察组和健康组孕妇的TSH水平、胎儿的头颅双顶径之间无明显统计学差异(P>0.05)。结论妊娠期亚临床甲状腺功能减退会对母婴造成严重危害,而规范的药物干预可促进胎儿在子宫内的生长发育,减少孕妇妊娠相关并发症,获得与健康孕妇相接近的妊娠结局。
Objective:Analysis of pregnancy outcomes of subclinical hypothyroidism during pregnancy after clinical intervention. Methods:Women who received subclinical hypothyroidism during pregnancy from June 2016 to June 2018 were divided into observation group 142 and control group according to whether they received levothyroxine sodium tablets. At the same time,50 healthy pregnant women were selected as the health group. Three groups of thyroid function,fetal biparietal diameter,pregnancy complications and pregnancy outcome were observed. Results:The incidence of abortion,gestational diabetes,anemia,premature delivery,low birth weight infants and intrauterine distress in the control group were significantly higher than those in the observation group and the healthy group(P<0.05). There was no statistically significant difference between the observation group and the healthy group(P>0.05). After two-two comparison,there was no significant difference in the incidence of fetal death between the three groups(P>0.05). At 37 weeks,the TSH level of the control group was significantly higher than that of the observation group and the healthy group. The fetal biparietal diameter was significantly smaller than that of the observation group and the healthy group,and the difference was statistically significant(P<0.05). There was no significant difference between the TSH level of the pregnant women in the observation group and the healthy group and the biparietal diameter of the fetus(P>0.05). Conclusion:Subclinical hypothyroidism during pregnancy can cause serious harm to mothers and children,and standardized drug intervention can promote the growth and development of the fetus in the womb,reduce pregnancyrelated complications in pregnant women,and obtain pregnancy outcomes close to healthy pregnant women.
Objective:Analysis of pregnancy outcomes of subclinical hypothyroidism during pregnancy after clinical intervention. Methods:Women who received subclinical hypothyroidism during pregnancy from June 2016 to June 2018 were divided into observation group 142 and control group according to whether they received levothyroxine sodium tablets. At the same time,50 healthy pregnant women were selected as the health group. Three groups of thyroid function,fetal biparietal diameter,pregnancy complications and pregnancy outcome were observed. Results:The incidence of abortion,gestational diabetes,anemia,premature delivery,low birth weight infants and intrauterine distress in the control group were significantly higher than those in the observation group and the healthy group(P<0.05). There was no statistically significant difference between the observation group and the healthy group(P>0.05). After two-two comparison,there was no significant difference in the incidence of fetal death between the three groups(P>0.05). At 37 weeks,the TSH level of the control group was significantly higher than that of the observation group and the healthy group. The fetal biparietal diameter was significantly smaller than that of the observation group and the healthy group,and the difference was statistically significant(P<0.05). There was no significant difference between the TSH level of the pregnant women in the observation group and the healthy group and the biparietal diameter of the fetus(P>0.05). Conclusion:Subclinical hypothyroidism during pregnancy can cause serious harm to mothers and children,and standardized drug intervention can promote the growth and development of the fetus in the womb,reduce pregnancyrelated complications in pregnant women,and obtain pregnancy outcomes close to healthy pregnant women.
引文
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[9]朱盼东,王昕,李静.妊娠期合并亚临床甲状腺功能减退对母婴结局的影响[J].临床输血与检验,2017,19(4):394-396.
[10]刘洪,冯小兰,袁晓玲,等.左旋甲状腺激素替代治疗妊娠期合并亚临床甲状腺功能减退对胎儿宫内发育及妊娠结局的影响[J].中国现代医生,2018,56(11):91-94.
[2]蔺莉.妊娠期亚临床甲状腺功能减退诊治进展[J].中华医学信息导报,2017,32(9):22.
[3]中华医学会内分泌学分会,中华医学会围产医学分会.妊娠和产后甲状腺疾病诊治指南[J].中华围产医学杂志,2012,15(7):385-403.
[4]李自尊.妊娠期甲状腺激素缺乏的危害及补碘重要性的研究进展[J].河北医科大学学报,2018,39(4):488-492.
[5]陈冰.孕期TSH、TPO-AB、FT4等检测、干预与母胎并发症相关性研究分析[D].上海第二军医大学,2012.
[6]孙玲,冯丽娟.孕妇亚临床甲状腺功能减退对婴幼儿神经心理发育的影响[J].中国妇幼保健,2017,32(19):4719-4721.
[7]陈刚,高燕云.妊娠亚临床甲减对胎儿发育及妊娠结局的影响[J].中国妇幼健康研究,2013,24(5):698-700.
[8]刘思诗,刘彩霞.妊娠期临床甲状腺功能减退症的诊断标准及危害和处理[J].实用妇产科杂志,2015,31(12):888-890.
[9]朱盼东,王昕,李静.妊娠期合并亚临床甲状腺功能减退对母婴结局的影响[J].临床输血与检验,2017,19(4):394-396.
[10]刘洪,冯小兰,袁晓玲,等.左旋甲状腺激素替代治疗妊娠期合并亚临床甲状腺功能减退对胎儿宫内发育及妊娠结局的影响[J].中国现代医生,2018,56(11):91-94.