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分化型甲状腺癌放射性碘治疗后的妊娠结局

Outcome of pregnancy after radioactive iodine treatment for well differentiated thyroid carcinomas.

作者信息

Lin J D, Wang H S, Weng H F, Kao P F

机构信息

Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan, R.O.C.

出版信息

J Endocrinol Invest. 1998 Nov;21(10):662-7. doi: 10.1007/BF03350795.

Abstract

This study sought to determine the outcome of pregnancy in female patients with differentiated thyroid carcinoma who became pregnant after radioactive iodide treatment. A total of 779 female thyroid cancer patients were treated at Chang Gung Medical Center in Linkou between January 1977 and December 1995. The medical records of these patients were reviewed retrospectively. Thirty-seven of these patients had well differentiated thyroid carcinoma receiving 131I treatment and conceived at a mean age of 27.97 +/- 3.49 year-old. A total of 58 pregnancy episodes were recorded during this study period. Among these 37 patients, 3 episodes of artificial abortion, 8 episodes of spontaneous abortion and 2 threatened abortions were observed. These patients delivered a total of 47 babies including 3 premature babies. Seven of these patients conceived within 6 months after the last administration of 131I, including 2 cases within 1 month, 4 cases within 4 months, and 1 patient within 5 months. Of these 7 patients, only one patient who conceived within 6 months after the last administration of 131I (14.3%) had a spontaneous abortion. The present results suggest that previous administration of 131I in female patients with well differentiated thyroid cancer does not result in demonstrable adverse effects in subsequent pregnancies. However, further studies involving long-term follow-up of children delivered by mothers who became pregnant within 6 months after the last administration of 131I is needed to further elucidate the possible chronic effects and sequelae of 131I therapy on subsequent pregnancies.

摘要

本研究旨在确定分化型甲状腺癌女性患者在接受放射性碘治疗后怀孕的妊娠结局。1977年1月至1995年12月期间,共有779名女性甲状腺癌患者在林口长庚纪念医院接受治疗。对这些患者的病历进行了回顾性分析。其中37例患者患有高分化甲状腺癌,接受了131I治疗,平均怀孕年龄为27.97±3.49岁。在本研究期间共记录到58次妊娠。在这37例患者中,观察到3例人工流产、8例自然流产和2例先兆流产。这些患者共分娩47名婴儿,其中包括3名早产儿。其中7例患者在最后一次服用131I后6个月内怀孕,包括2例在1个月内、4例在4个月内、1例在5个月内怀孕。在这7例患者中,只有1例在最后一次服用131I后6个月内怀孕的患者(14.3%)发生了自然流产。目前的结果表明,既往接受131I治疗的高分化甲状腺癌女性患者在随后的妊娠中未出现明显的不良影响。然而,需要对最后一次服用131I后6个月内怀孕的母亲所分娩儿童进行长期随访的进一步研究,以进一步阐明131I治疗对随后妊娠可能产生的慢性影响和后遗症。

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