短期胰岛素泵强化治疗对妊娠期糖尿病妊娠结局的影响

Relationship between short - term intensified insulin pump in treating gestationai diabetes mellitus and gestational outcomes.

目的研究连续皮下胰岛素输注短期强化治疗妊娠期糖尿病的临床效果。方法选择2007年1月～2009年3月笔者所在医院产科治疗的69例妊娠期糖尿病患者，分为CSII组及MSII组，并根据血糖检测结果调整胰岛素用量，比较两组血糖控制达标时间、日均胰岛素用量以及妊娠并发症的发生情况。结果两组血糖控制水平相比差异无统计学意义（P〉0．05）。但CSII组血糖控制达标时间[（3．13±0．98）d]较MSII组[（7．82±1．98）d]缩短约4．75d，差异有统计学意义（P〈0．01）。CSII组日均胰岛素用量[（28．95±8．59）U／d]较MSII组[（42．16±9．03）U／d]亦明显减少（P〈0．01）。两组妊娠并发症如妊娠期高血压疾病、早产以及孕妇低血糖的发生率比较差异均有统计学意义（P〈0．05）。结论胰岛素泵短期强化治疗妊娠期糖尿病临床应用效果优于传统的胰岛素多次皮下注射方式，能明显改善妊娠期糖尿病的妊娠结局。

Objective To evaluate the effect of short - term intensified insulin pump in treating gestational diabetes. Methods A total of 69 patients treated in the 2nd affiliated hospital of Guangzhou medical college from January 2007 to March 2009 were enrolled in the study and were divided into CSII group and multiple subcutaneous insulin injection（MSII） group. We monitored the blood glucose level and adjusted the dosage of insulin. We evaluated the blood glucose level, daily insulin dosage,time for the successful treatment, and maternal and neonatal complications. Results The fasting and postprandial （2h） blood glucose levels were successtully controlled to normal ranges in both groups （P 〉 0.05）. However,the daily insulin dosage and the time for the successful treatment were both significantly lower in CSII group than those in the MSII group（28.95 ± 8.59U/d vs42.16 ±9.03U/d） and（3.13 ±0.98） days vs（7.82 ± 1.98） days,respectively（P 〈0.01 ）. The incidence of pregnancy- induced hypertension, pretenn delivery, and maternal hypoglycemia were also significantly lower in CSII group compared with MSII group（P 〈0.05）. Conclusion The clinical effect of short - term intensified insulin pump treatment on CDM better than traditional multiple subcutaneous insulin injection. In the meanwhile,CSII can evidently better the gestational outcome on GDM.