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目的探讨胰岛素对不同孕周妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖水平及妊娠结局的影响。方法选取2013年2月至2016年5月在海南现代妇婴医院产检及生产的GDM患者共117例,根据胰岛素首次治疗孕周分为研究组59例(≤32孕周)和对照组58例(>32孕周)。两组患者均在坚持合理运动、饮食基础上行胰岛素治疗,比较两组血糖水平变化、妊娠结局以及新生儿并发症情况。结果两组分娩前血糖水平(空腹和餐后2 h)均低于入院时(P<0.05),且研究组血糖水平比对照组降低更明显,差异有统计学意义(P<0.05);两组剖宫产发生率比较差异无统计学意义(P>0.05),研究组妊娠期高血压疾病、羊水过多、产后出血感染发生率均低于对照组(P<0.05),早产发生率高于对照组(P<0.05);两组巨大儿发生率比较差异无统计学意义(P>0.05),研究组新生儿窒息、新生儿低血糖、高胆红素血症、低体重儿发生率均低于对照组(P<0.05)。结论 GDM患者在32孕周前采取胰岛素治疗,可有效控制血糖水平,改善妊娠结局,取得满意的临床效果。
Objective To investigate the effect of insulin on blood glucose level and pregnancy outcome in gestational diabetes mellitus (GDM). Methods A total of 117 GDM patients who were examined and produced in Hainan Modern Maternity and Infant Hospital from February 2013 to May 2016 were divided into study group (n = 32 weeks) and control group (n = 58) according to the first gestational week of insulin treatment. (> 32 gestational weeks). Both groups were insisting on reasonable exercise, insulin-based diet on the basis of changes in blood glucose levels, pregnancy outcomes and neonatal complications. Results The blood glucose level before delivery in both groups (fasting and postprandial 2 h) was lower than that at admission (P <0.05), and the blood sugar level in the study group was significantly lower than that in the control group (P <0.05) There was no significant difference in the incidence of cesarean section between the two groups (P> 0.05). The incidence of gestational hypertension, polyhydramnios and postpartum hemorrhagic infection were lower in the study group than in the control group (P <0.05) (P <0.05). There was no significant difference in the incidence of macrosomia between the two groups (P> 0.05). The incidence of neonatal asphyxia, neonatal hypoglycemia, hyperbilirubinemia and low birth weight Were lower than the control group (P <0.05). Conclusion GDM patients take insulin therapy before 32 weeks gestation, which can effectively control blood sugar level, improve pregnancy outcome and achieve satisfactory clinical effect.