甲亢外科手术治疗后妊娠对孕妇甲状腺功能及妊娠结局的影响

Thyroid function and pregnancy outcomes of pregnant women affected by surgical treatment of hyperthyroidism

目的:研究甲亢手术治疗后妊娠患者的甲状腺功能和妊娠结局情况。方法:临床纳入116例2003年8月至2016年8月期间我院收治的甲亢治疗后妊娠孕妇作为研究对象,按甲亢治疗方式分为手术组和药物组各58例。另选取健康孕妇50例作为对照组。观察三组孕妇甲状腺功能、妊娠结局以及并发症情况。结果:治疗前两组患者TSH、T3以及T4水平比较差异无统计学意义(P>0.05);治疗后手术组患者TSH、T3以及T4水平均优于药物组(P<0.05);手术组与对照组比较差异无统计学意义(P>0.05)。手术组、药物组产妇结局和胎儿结局与对照组比较差异无统计学意义(P>0.05)。手术组并发症发生率仅为3.45%,明显低于对照组的15.52%。结论:甲亢外科手术治疗后妊娠孕妇甲状腺功能与正常人群无差异,妊娠结局无明显影响,且术后并发症较少,值得临床应用及推广。

Objective: To investigate the thyroid function and pregnancy outcomes of pregnant patients affected by the surgical treatment of hyperthyroidism. Methods: A total of 116 pregnant women,received surgical treatment of hyperthyroidism before pregnancy in our hospital between August 2003 and August 2016,were included as the subjects in the study. According to the treatment of hyperthyroidism,all pregnant women were divided into the surgery group and drug group( n = 58 each). A contemporary cohort of 50 healthy pregnant women was included as the control group. The thyroid function,pregnancy outcomes and complications in the three groups were determined. Results: There were no differences in TSH,T3 and T4 levels between the two groups at baseline,P>0.05. The TSH,T3 and T4 levels in the surgery group were better than those in the drug group after the treatment,P < 0. 05. There was no difference between the surgery group and the control group,P>0.05. There were no differences in the maternal and fetal outcomes between the operation group/drug group and the control group,P>0.05. The incidence of complications in the operation group was significantly lower than that in the control group( 3. 45% vs. 15. 52%). Conclusion: There is no difference in the thyroid function between pregnant women received surgical treatment of hyperthyroidism before pregnancy and the normal subjects.The surgical treatment of hyperthyroidism shows no significant effect on pregnancy outcomes with less postoperative complications,which justifies widespread use in the clinical settings.