本文選題：甲狀腺功能減退 + 妊娠期亞臨床甲減��； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：研究妊娠期間甲狀腺功能減退癥對孕婦妊娠結(jié)局及并發(fā)癥的影響因素，為臨床治療提供參考。 方法：回顧性研究在我院產(chǎn)科分娩的妊娠合并甲狀腺功能減退癥151例病例資料。根據(jù)妊娠期間首次發(fā)現(xiàn)并確診甲狀腺功能減退癥時的診斷，分為妊娠期臨床甲狀腺功能減退和妊娠期亞臨床甲狀腺功能減退，分析其影響因素及并發(fā)癥。 結(jié)果：⑴各組發(fā)生流產(chǎn)例數(shù)占總例數(shù)的百分比差別不大。甲減組的平均流產(chǎn)次數(shù)顯著高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；亞甲減組的平均流產(chǎn)次數(shù)略高于對照組，差異不具有統(tǒng)計(jì)學(xué)意義（P0.05）；甲減組的平均流產(chǎn)次數(shù)略高于亞甲減組，差異不具有統(tǒng)計(jì)學(xué)意義（P0.05）。⑵各組間的平均終止妊娠天數(shù)均無明顯的差別，均無統(tǒng)計(jì)學(xué)意義（P0.05）。甲減組的平均新生兒體重明顯低于對照組，，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；亞甲減組的平均新生兒體重明顯低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；甲減組的平均新生兒體重略低于亞甲減組，差異無統(tǒng)計(jì)學(xué)意義（P0.05）。⑶根據(jù)孕期發(fā)現(xiàn)并確診為亞臨床甲減的時機(jī)將亞臨床甲減組又分為入院前組和入院后組，同時設(shè)立一個對照組，其中入院前組在發(fā)現(xiàn)并確診時即給予相應(yīng)的治療至分娩，入院后組在入院發(fā)現(xiàn)并確診時即給予相應(yīng)治療。比較各組間入院分娩時的TSH值。入院前組的TSH明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；入院后組的TSH明顯高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；入院后組的TSH明顯高于入院前組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。⑷甲減組與亞甲減組在此次妊娠年齡中位數(shù)之間的差異有統(tǒng)計(jì)學(xué)意義（P0.05），亞甲減組在25歲年齡≤30歲的人數(shù)最多，主要集中于25歲年齡≤35歲，甲減組在30歲年齡≤35歲的人數(shù)最多，主要集中于年齡30歲。⑸甲減組合并妊高癥的發(fā)生率略高于亞甲減組，差異無統(tǒng)計(jì)學(xué)意義（P0.05）。亞甲減組合并妊高癥在25歲年齡≤30歲的人數(shù)最多，主要集中于25歲年齡≤35歲，甲減組合并妊高癥在30歲年齡≤35歲的人數(shù)最多，主要集中于年齡30歲。 結(jié)論：1、妊娠期甲狀腺功能減退癥可誘發(fā)一系列的產(chǎn)前、產(chǎn)時和產(chǎn)后并發(fā)癥，導(dǎo)致不良的妊娠結(jié)局。2、妊娠期甲狀腺功能減退癥與年齡、流產(chǎn)次數(shù)有一定相關(guān)性，流產(chǎn)次數(shù)越多，年齡較大均可使妊娠期甲減的發(fā)生率增高。3、妊娠期甲狀腺功能減退癥伴有妊娠期高血壓疾病的發(fā)生率增高，提示妊娠期甲狀腺功能的異常可能是誘發(fā)妊娠期高血壓疾病的危險因素之一。4、患有妊娠期臨床甲減的婦女與正常妊娠婦女相比，終止妊娠的天數(shù)無明顯差異，前者的新生兒體重偏低。5、加強(qiáng)人們對妊娠期甲減的正確認(rèn)識，普及相關(guān)知識，使有條件的婦女在孕前和產(chǎn)前都能夠定期檢查甲狀腺功能，有效預(yù)防不良妊娠結(jié)局，提高妊娠的質(zhì)量。
[Abstract]:Objective: to study the influence factors of hypothyroidism on pregnancy outcome and complications during pregnancy, and to provide reference for clinical treatment. Methods: 151 cases of pregnancy complicated with hypothyroidism were retrospectively studied. According to the diagnosis of hypothyroidism found and diagnosed for the first time during pregnancy, it was divided into clinical hypothyroidism and subclinical hypothyroidism during pregnancy. The influencing factors and complications were analyzed. Results there was no significant difference in the percentage of miscarriages in the total number of miscarriages in each group. The average number of miscarriages in hypothyroidism group was significantly higher than that in control group (P 0.05), the average abortion frequency in hypothyroidism group was slightly higher than that in control group (P 0.05), and the average abortion frequency in hypothyroidism group was slightly higher than that in subhypothyroidism group. There was no significant difference in the average number of days of termination of pregnancy between the two groups, and there was no significant difference in the number of days of termination of pregnancy between the two groups. The average neonatal weight in the hypothyroidism group was significantly lower than that in the control group (P 0.05), and the average neonatal weight in the hypothyroidism group was slightly lower than that in the hypothyroidism group. The subclinical hypothyroidism group was subdivided into pre-admission group and post-admission group according to the timing of detection and diagnosis of subclinical hypothyroidism during pregnancy, and a control group was set up at the same time. The patients in the pre-admission group were given corresponding treatment to labor when they were found and diagnosed, and the patients in the post-admission group were given the corresponding treatment when they were found and diagnosed. The TSH values at admission to labor were compared among the groups. The TSH of the group before admission was significantly higher than that of the control group (P 0.05), the TSH of the group after admission was significantly higher than that of the group before admission. There was significant difference between hypothyroidism group and subhypothyroidism group in the median gestational age (P 0.05). The subthyroidism group was the most common group in the age of 25 years or less than 30 years old, mainly in the age of 25 years 鈮

本文編號：1955509