不同孕期妊娠期糖尿病孕妇胰岛素皮下注射对血糖控制及妊娠结局的影响

Effect of Subcutaneous Insulin Injection on Blood Glucose Control and Pregnancy Outcome in Pregnant Women with Diabetes in Different Pregnancy Periods

目的比较不同孕期妊娠期糖尿病(GDM)孕妇行胰岛素皮下注射的血糖控制效果及对妊娠结局的影响.方法选择2021年1月—2022年12月该院妇产科收治的60例GDM孕妇为研究对象.所有孕妇均行胰岛素皮下注射治疗,以孕周32周为界限进行分组,各30例,观察组于孕32周前治疗,对照组于孕32周后治疗.比较两组血糖水平,随访孕妇分娩方式、妊娠结局.结果治疗前,两组产妇空腹血糖(FPG)、餐后2h血糖(2 hPG)水平比较,组间差异无统计学意义(P>0.05);分娩前,观察组FPG、2 hPG水平均低于对照组,组间差异有统计学意义(P<0.05).观察组分娩孕周长于对照组,所产新生儿Apgar评分高于对照组,组间差异有统计学意义(P<0.05).观察组自然分娩率76.67%高于对照组的50.00%,差异有统计学意义(P<0.05).观察组产妇不良结局及所产新生儿不良结局发生率分别为6.67%、16.67%,均低于对照组的26.67%、43.33%,组间差异有统计学意义(P<0.05).结论孕32周前行胰岛素皮下注射治疗有利于提升GDM孕妇血糖控制效果,改善母婴妊娠结局,提升自然分娩率,值得推广.

Objective To compare the effect of subcutaneous insulin injection on blood glucose control and pregnancy outcome in pregnant women with diabetes mellitus(GDM)in different pregnancy periods.Methods Sixty GDM pregnant women admitted to the Obstetrics and Gynecology department of the hospital from January 2021 to December 2022 were selected as the research subjects.All pregnant women were treated with insulin subcutaneous injection,and were divided into 30 cases each at 32 weeks of gestation.The observation group was treated before 32 weeks of pregnancy,the control group was treated after 32 weeks of pregnancy.Compare the blood glucose levels of two groups,and follow up on the delivery method and pregnancy outcome of pregnant women.Results Before treatment,there was no statistically significant difference in the levels of fasting blood glucose(FPG)and 2-hour postprandial blood glucose(2 h PG)between the two groups of postpartum women(P>0.05);before delivery,the FPG and 2 h PG in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The observation group had a longer gestational age than the control group,and the Apgar score of newborns was higher than that of the control group,and the differences between the groups were statistically significant(P<0.05).The natural delivery rate of 76.67%in the observation group was higher than 50.00%in the control group,with a statistically significant difference(P<0.05).The incidence rates of adverse outcomes in the observation group were 6.67%for postpartum women and 16.67%for newborns,respectively,which were lower than 26.67%and 43.33%in the control group,with statistically significant differences between the groups(P<0.05).Conclusion Subcutaneous insulin injection therapy before 32 weeks of pregnancy is beneficial for improving the blood sugar control effect of GDM pregnant women,improving maternal and infant pregnancy outcomes,and increasing the natural delivery rate.It is worth promoting.