甲状腺乳头状癌术后妊娠患者母儿结局分析  

Analysis of maternal and fetal outcomes after papillary thyroid cancer surgery

作　　者：左鹏 杨京晶[1] ZUO Peng;YANG Jingjing(Department of Obstetrics and Gynecology,Peking University People’s Hospital,Beijing100044,China)

机构地区：[1]北京大学人民医院妇产科,100044

出　　处：《中国妇产科临床杂志》2022年第2期157-159,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨甲状腺乳头状癌术后合并妊娠患者的母儿结局。方法选取2014年1月至2020年1月在北京大学人民医院产科建档并住院分娩的甲状腺乳头状癌术后合并妊娠患者57例作为研究组;选取同期在本院建档分娩的单胎妊娠122例作为对照组。按照妊娠期甲状腺功能(甲功)情况将研究组分为亚临床甲状腺功能亢进组(甲亢组)、亚临床甲状腺功能减退组(甲减组)及甲功正常组。结果57例患者共61次妊娠,共获得活产新生儿56例。因胎儿畸形妊娠中期引产4例,难免流产1例。活产新生儿中,阴道分娩34例(60.7%),剖宫产22例(39.3%)。与对照组比较,研究组在妊娠期糖尿病、剖宫产、产后出血及胎儿畸形发生率方面均高于对照组(P<0.05)。研究组中妊娠期合并亚临床甲亢患者14例,亚临床甲减患者3例,甲功正常患者44例。与正常组比较,亚临床甲亢组及亚临床甲减组的母儿并发症发生率比较,差异均无统计学意义(P>0.05)。结论甲状腺乳头状癌术后合并妊娠患者妊娠并发症增加,应加强妊娠期对母儿并发症的监测,以期改善母儿结局。Objective To investigate the maternal and fetal outcomes after papillary thyroid cancer surgery.Methods From January 2014 to January 2020,57 pregnant women with thyroid papillary cancer after surgery who were registered in the Department of Obstetrics,Peking University People’s Hospital and hospitalized for delivery were selected as the research group.A total of 122 single pregnancy cases registered in our hospital were selected as normal control group.The study group was divided into subclinical hyperthyroidism(hyperthyroidism group),subclinical hypothyroidism(hypothyroidism group)and normal thyroid function group according to the thyroid function during pregnancy.Results There were 61 pregnancies in 57 patients.56 cases achieved live birth,4 cases underwent induced labor because of fetal malformation during the second trimester,1 case underwent inevitable miscarriage.There were 34 cases of vaginal delivery(60.7%)and 22 cases of cesarean section(39.3%).The research group showed higher incidence in gestational diabetes mellitus,cesarean section,postpartum hemorrhage and fetal malformation than the control group(P<0.05).In the research group,there were 14 pregnant patients with subclinical hyperthyroidism,3 with subclinical hypothyroidism,and 44 with normal thyroid function.Compared with normal group,there was no difference in the incidence of maternal and fetal complications between subclinical hyperthyroidism group and subclinical hypothyroidism group(P>0.05).Conclusion It was suggested that there were maternal and fetal complications among patients after papillary thyroid cancer surgery.Management of these patients requires a careful gestational monitoring and surveillance to improve the outcomes.

关 键 词：甲状腺乳头状癌生存者 妊娠 母儿结局 

分 类 号：R736.1[医药卫生—肿瘤] R714.2[医药卫生—临床医学]