本文選題：甲狀腺功能減退 + 治療　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：研究甲狀腺功能減退與妊娠期高血壓疾病之間的關(guān)系，比較分析應(yīng)用甲狀腺素治療后妊娠期高血壓疾病的進(jìn)展、愈后及妊娠結(jié)局的分析。 方法：回顧性分析2012年1月—2013年12月在我院產(chǎn)科分娩的甲狀腺功能減退伴妊娠期高血壓疾�。ò▉喤R床甲狀腺功能減退）患者118例病例資料。針對(duì)甲狀腺功能減退用藥的治療情況（甲狀腺素）分為治療組和非治療組，并隨機(jī)抽取在此期間患妊娠期高血壓疾�。ú话橛屑谞钕俟δ軠p退）的患者80例做為對(duì)照組。 結(jié)果：⑴流產(chǎn)情況。非治療組的平均流產(chǎn)次數(shù)顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；非治療組的平均流產(chǎn)次數(shù)高于治療組，差異具有統(tǒng)計(jì)學(xué)意義（P0.05）；治療組的平均流產(chǎn)次數(shù)略高于對(duì)照組，差異不具有統(tǒng)計(jì)學(xué)意義（P0.05）。⑵終止妊娠時(shí)間：治療組的平均終止妊娠周數(shù)顯著晚于非治療組，差異具有統(tǒng)計(jì)學(xué)意義（P0.05）。治療組終止妊娠時(shí)間略晚于對(duì)照組。差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。非治療組的終止妊娠時(shí)間早于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。⑶治療組的平均新生兒體重顯著高于非治療組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；非治療組的平均新生兒體略低于對(duì)照組，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）；治療組的平均新生兒體重略略高于對(duì)照組，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。⑷非治療組患者（血壓》160/100mmHg尿蛋白：3+）既重度子癇前期患者比例顯著高于治療組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；非治療組患者（血壓》160/100mmHg尿蛋白：3+）既重度子癇前期患者比例顯著高于對(duì)照組，，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；治療組重度子癇前期患者比例與對(duì)照組無(wú)顯著差異，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。⑸新生兒體重：非治療組體重略低于治療組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）；治療組新生兒體重與對(duì)照組新生兒體重?zé)o明顯區(qū)別，差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。統(tǒng)計(jì)中發(fā)現(xiàn)妊娠期高血壓疾病伴甲狀腺功能減退患者的年齡在25歲年齡≤35歲的人數(shù)較多，平均年齡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(shí)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流產(chǎn)次數(shù)增多。3、妊娠期高血壓疾病的發(fā)生率增高：高血壓的嚴(yán)重程度與甲減的嚴(yán)重程度相關(guān)。妊娠期甲狀腺功能減退癥者患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是誘發(fā)妊娠期高血壓疾病的危險(xiǎn)因素之一。4、患有妊娠期甲狀腺功能減退伴妊娠期高血壓疾病的婦女，其妊娠期高血壓的發(fā)病時(shí)間、癥狀嚴(yán)重程度、終止妊娠的周數(shù)與及時(shí)、有效的補(bǔ)充甲狀腺素有關(guān)，積極糾正甲狀腺功能減退，可減輕妊娠期高血壓疾病的癥狀、適當(dāng)延長(zhǎng)孕周，提高新生兒存活率。5、提高人們對(duì)妊娠期甲狀腺功能普查的意識(shí)，積極做到盡早發(fā)現(xiàn)、及時(shí)治療。
[Abstract]:Aim: to study the relationship between hypothyroidism and hypertensive disorder complicating pregnancy, and to compare and analyze the progress, recovery and outcome of hypertensive disorder complicating pregnancy after thyroxine therapy. Methods: the data of 118 cases of hypothyroidism and hypertensive disorder complicating pregnancy (including subclinical hypothyroidism) delivered in our hospital from January 2012 to December 2013 were retrospectively analyzed. According to the treatment of hypothyroidism (thyroxine), the patients were divided into treatment group and non-treatment group, and 80 patients with hypertensive disorder complicating pregnancy (without hypothyroidism) were randomly selected as control group. The result was: 1 abortion. The average number of abortions in the non-treatment group was significantly higher than that in the control group, the difference was statistically significant (P0.05); the average number of abortions in the non-treatment group was higher than that in the treatment group (P0.05); the average number of abortions in the treatment group was slightly higher than that in the control group (P0.05). The difference was not statistically significant (P0.05) .2 termination of pregnancy: the average number of weeks of termination of pregnancy in the treatment group was significantly later than that in the non-treatment group, the difference was statistically significant (P0.05). The termination of pregnancy in the treatment group was slightly later than that in the control group. The difference was not statistically significant (P0.05). The termination time of pregnancy in the non-treatment group was earlier than that in the control group, the difference was statistically significant (P0.05). 3. The average neonatal weight in the treatment group was significantly higher than that in the non-treatment group (P0.05), and the average neonatal body mass in the non-treatment group was slightly lower than that in the control group (P0.05). The average neonatal weight in the treatment group was slightly higher than that in the control group (P0.05). The proportion of severe preeclampsia patients in the non-treatment group (blood pressure > 160 / 100 mmHg urine protein: 3) was significantly higher than that in the treatment group. The proportion of patients with severe preeclampsia in non-treatment group (blood pressure > 160 / 100mmHg urine protein: 3) was significantly higher than that in control group (P0.05). The proportion of patients with severe preeclampsia in the treatment group and the control group had no significant difference (P0.05). 5. Neonatal weight: the weight of the non-treatment group was slightly lower than that of the treatment group (P0.05). There was no significant difference in neonatal weight between the treatment group and the control group (P0.05). It was found that the age of hypertensive disorder complicating pregnancy with hypothyroidism was more than 25 years old and less than 35 years old, with an average age of 30 years. Conclusion gestational hypothyroidism can induce a series of complications before, during and after delivery. The incidence of hypertension complicating pregnancy was increased. The severity of hypertension was related to the severity of hypothyroidism. The incidence of hypertensive disorder complicating pregnancy was increased in patients with hypothyroidism during pregnancy. It is suggested that abnormal thyroid function during pregnancy is one of the risk factors to induce hypertensive disorder complicating pregnancy. The onset time and severity of symptoms of hypertensive disorder complicating pregnancy in women with hypothyroidism complicating pregnancy and hypertensive disorder complicating pregnancy. The number of weeks of termination of pregnancy is related to the timely and effective supplement of thyroxine and the positive correction of hypothyroidism, which can alleviate the symptoms of hypertensive disorder complicating pregnancy and extend the gestational week appropriately. Improve neonatal survival rate. 5. Improve people's awareness of gestational thyroid function survey, actively achieve early detection and timely treatment.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R581.2;R714.246

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