住院妊娠妇女甲状腺功能低下发病现状及影响因素分析

发布时间：2018-05-30 13:45

  本文选题：甲状腺功能减退 + 妊娠期亚临床甲减　； 参考：《吉林大学》2014年硕士论文

【摘要】：目的：研究妊娠期间甲状腺功能减退症对孕妇妊娠结局及并发症的影响因素，为临床治疗提供参考。 方法：回顾性研究在我院产科分娩的妊娠合并甲状腺功能减退症151例病例资料。根据妊娠期间首次发现并确诊甲状腺功能减退症时的诊断，分为妊娠期临床甲状腺功能减退和妊娠期亚临床甲状腺功能减退，分析其影响因素及并发症。 结果：⑴各组发生流产例数占总例数的百分比差别不大。甲减组的平均流产次数显著高于对照组，差异有统计学意义（P0.05）；亚甲减组的平均流产次数略高于对照组，差异不具有统计学意义（P0.05）；甲减组的平均流产次数略高于亚甲减组，差异不具有统计学意义（P0.05）。⑵各组间的平均终止妊娠天数均无明显的差别，均无统计学意义（P0.05）。甲减组的平均新生儿体重明显低于对照组，，差异有统计学意义（P0.05）；亚甲减组的平均新生儿体重明显低于对照组，差异有统计学意义（P0.05）；甲减组的平均新生儿体重略低于亚甲减组，差异无统计学意义（P0.05）。⑶根据孕期发现并确诊为亚临床甲减的时机将亚临床甲减组又分为入院前组和入院后组，同时设立一个对照组，其中入院前组在发现并确诊时即给予相应的治疗至分娩，入院后组在入院发现并确诊时即给予相应治疗。比较各组间入院分娩时的TSH值。入院前组的TSH明显高于对照组，差异有统计学意义（P0.05）；入院后组的TSH明显高于对照组，差异有统计学意义（P0.05）；入院后组的TSH明显高于入院前组，差异有统计学意义（P0.05）。⑷甲减组与亚甲减组在此次妊娠年龄中位数之间的差异有统计学意义（P0.05），亚甲减组在25岁年龄≤30岁的人数最多，主要集中于25岁年龄≤35岁，甲减组在30岁年龄≤35岁的人数最多，主要集中于年龄30岁。⑸甲减组合并妊高症的发生率略高于亚甲减组，差异无统计学意义（P0.05）。亚甲减组合并妊高症在25岁年龄≤30岁的人数最多，主要集中于25岁年龄≤35岁，甲减组合并妊高症在30岁年龄≤35岁的人数最多，主要集中于年龄30岁。 结论：1、妊娠期甲状腺功能减退症可诱发一系列的产前、产时和产后并发症，导致不良的妊娠结局。2、妊娠期甲状腺功能减退症与年龄、流产次数有一定相关性，流产次数越多，年龄较大均可使妊娠期甲减的发生率增高。3、妊娠期甲状腺功能减退症伴有妊娠期高血压疾病的发生率增高，提示妊娠期甲状腺功能的异常可能是诱发妊娠期高血压疾病的危险因素之一。4、患有妊娠期临床甲减的妇女与正常妊娠妇女相比，终止妊娠的天数无明显差异，前者的新生儿体重偏低。5、加强人们对妊娠期甲减的正确认识，普及相关知识，使有条件的妇女在孕前和产前都能够定期检查甲状腺功能，有效预防不良妊娠结局，提高妊娠的质量。
[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

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