妊娠期糖尿病筛查、合理干预治疗与妊娠结局分析

Screening for gestational diabetes mellitus reasonable therapeutis intervention analysis and the outcome of pregnancy

目的广泛开展妊娠期糖尿病筛查,以便合理干预治疗,改善母婴预后。方法对2006年12月～2008年4月在本院进行产前检查孕妇,于妊娠24～28周进行糖筛查共1246例,筛查出妊娠期糖尿病42例(GDM组),妊娠期糖耐量异常31例(GIGT组),正常组孕妇1173例(对照组),采用回顾性分析的方法分别对3组母婴结局进行分析。结果妊娠合并糖代谢异常发病率5.81%,2组糖代谢异常组总的巨大儿,子痫前期早产发病率分别为12.3%,8.2%,和6.8%,均明显高于对照组孕妇(P<0.01),GDM组新生儿窒息,低血糖及转诊率高于GIGT组(P<0.01)。结论①妊娠合并糖代谢异常逐年增加,应加强糖筛查重要性的广泛宣传工作,提高群众对此项筛查的认识,主动配合,以防漏诊。②巨大儿、子痫前期和早产认识糖代谢异常孕妇最常见并发症,加强该型糖尿病孕妇管理可有效改善母婴预后。

Objective Extensive efforts carrid out during pregnancy suger screeing,inorder to interfere with a reasonable treetment,to improve maternal and fetal progrosis. Methods 50gglucose screening test was conducted for 1256 cases pregnant women at 24-28weeks of pregnancy from December 2006 to Aprir 2008 the selected cases consisted of 42 women with gestational diabetes mellitus and 31with gestational impaired glucose test, 1173 women with normal glucose metabilism were analysed comparision. Results The total incidence of gestational abnormal glucose metalism was 5.81%,the incidence ofmacorsomia preeclampsia and preterm birth were 12.3%.8.2% and 6.8% which were significantly higher than those women with nomal glucose metabolism （P〈0.01）. Conclusion （1）The incidence of gestational abnormal glucose metabolism is increasing should strengthen the importance of sugar screening awide range of udvocacy work to improve public awareness of the screening awareness and take the initiative to meet in order to prevent misdiagnosis. （2）Macrosomia preeclampsia and preterm birth remain the first three common complications,standardlized glycemic managenent can improve mother-child prenosis.