妊娠合并亚临床甲状腺功能减退症的早期治疗对妊娠结局的影响

Effect of Early Treatment of Pregnancy with Subclinical Hypothyroidism on Pregnancy Outcome

目的探讨给予妊娠期间合并亚临床甲状腺功能减退症(SCH)的患者左甲状腺素(优甲乐)早期治疗对其妊娠结局的影响情况。方法随机抽取选取2015年6月—2017年12月该院收治的60例妊娠期间合并亚临床甲状腺功能减退症患者作为临床观察对象。采用单纯随机分组的方法分成治疗组(给予患者左甲状腺素(优甲乐)早期治疗,30例)和无治疗组(不给予患者早期治疗,30例)以及对照组(同一时间在该院住院的甲状腺功能正常的孕妇,30名)。对比观察3组患者产科并发症发生的概率、妊娠结局以及发生新生儿窒息概率的结果分析。结果治疗组发生产科并发症(胎膜早破13.33%、羊水量异常6.67%、产后出血3.33%)的概率明显低于无治疗组(20.00%、13.33%、10.00%);对照组组发生产科并发症(胎膜早破6.67%、羊水量异常6.67%、产后出血3.33%)的概率明显低于无治疗组;治疗组发生妊娠结局(早产13.33%、流产6.67%、死胎0.00%、新生儿窒息6.67%)的概率明显低于无治疗组(20.00%、13.33%、3.33%、10.00%);对照组组发生妊娠结局(早产6.67%、流产3.33%、死胎0.00%、新生儿窒息3.33%)的概率明显低于无治疗组,比较均差异有统计学意义(P<0.05)。结论给予妊娠期间合并亚临床甲状腺功能减退症(SCH)的患者优甲乐早期治疗治疗,其临床疗效好,作用较为全面,对孕妇及胎儿的不良反应较小,具有较高的安全性。

Objective To investigate the effect of early treatment of levothyroxine (euthyroxine) on pregnancy outcome in patients with subclinical hypothyroidism (SCH) during pregnancy. Methods A total of 60 patients with subclinical hypothyroidism who were admitted to our hospital from June 2015 to December 2017 were selected as clinical observation subjects. They were divided into treatment group by simple randomization (early treatment with levothyroxine (euthyroxine) 30 patients) and no treatment group (no treatment for early treatment, 30 patients) and control group (at the same time in our hospital, pregnant women with normal thyroid function, 30 cases). The results of obstetric complications, pregnancy outcomes, and the probability of neonatal asphyxia were analyzed in 3 groups. Results The probability of complications in the treatment group (13.33% premature rupture of membranes, 6.67% abnormal amniotic fluid, 3.33% postpartum hemorrhage) was significantly lower than that in the no treatment group (20.00%, 13.33%, 10.00%);the probability of complications in the control group (6.67% of premature rupture of membranes, 6.67% of abnormal amniotic fluid, 3.33% of postpartum hemorrhage) was significantly lower than that of no treatment group. The probability of pregnancy outcome in the treatment group (pre-production 13.33%, abortion 6.67%, stillbirth 0.00%, neonatal asphyxia 6.67%) was significantly lower than the no treatment group (20.00%, 13.33%, 3.33%, 10.00%);the probability of pregnancy outcome in the control group (6.67% of premature delivery, 3.33% of miscarriage, 0.00% of stillbirth, 3.33% of neonatal asphyxia) was significantly lower than that of no treatment group. the difference was statistically significant (P<0.05). Conclusion The early treatment of Eucalyptus in patients with subclinical hypothyroidism (SCH) during pregnancy has a good clinical effect and a comprehensive effect. It has less adrerse reaction on pregnant women and fetuses and has higher safety.