不同干预措施对妊娠期糖尿病孕妇血糖及妊娠结局的影响

Effect of different interventions to fasting blood glucose and pregnant outcome of pregnant women with gestationl diabetes mellitus

目的探讨不同干预措施对妊娠期糖尿病空腹血糖和对妊娠结局的影响,为血糖的控制及母婴健康水平的提高提供建议。方法将2006年1月至2007年12月在我院住院分娩并确诊为妊娠期糖尿病的患者158例进行干预。将研究对象随机分为干预组(78例)与对照组(80例),其中干预组进行以饮食指导与健康教育为主的综合干预措施,对照组实施常规的指导方式。随访两组的母体血糖控制及妊娠结局,并进行比较。结果干预后两组的血糖水平均有所降低,但干预组的空腹血糖明显低于对照组,且两组间的差异也具有统计学意义(P<0.05)。干预组共有5人(6.41%)接受胰岛素治疗,而对照组为13人(16.25%),差异具有统计学意义(P<0.05)。两组胎儿的出生体重分别为(3434±547)g和(3185±468)g,干预组的巨大儿发生率为3.85%,新生儿窒息发生率为3.85%,早产发生率为5.13%,均明显低于对照组的13.75%、16.25%和15.00%(P<0.05)。结论本研究表明合理的饮食指导配合健康教育可以有效地控制母体血糖,降低巨大儿、早产等不良妊娠结局的发生。不同等级的医疗机构应该根据自身状况展开实施。

Objective To explore the effect of different interventions on the patients with gestational diabetes fasting blood glucose and the influence on pregnancy outcome,and then provide information for blood glucose control and improve the health of mothers and infants.Methods 158 pregnant women with gestational diabetes were randomly divided into intervention group and control group,in which intervention group with dietary guidance and health education-based,integrated intervention of the control group to guide in conventional way. The maternal blood glucose level and pregnancy outcome were followed-up.Results The blood glucose level were all decreased after the intervention,but the intervention group was significantly lower than control group,and the difference between the two groups were also statistically significant （P0.05）. There were 5 （6.41%） patients in intervention group were receiving insulin treatment,while the control group were 13 （16.67%）,and the differences were also statistically significant （P0.05）. Fetal birth weight were （3 434±547）g and （3 185±468）g respectively,intervention group macrosomia incidence of 3.85%,neonatal asphyxia incidence of 3.85%,premature birth rate of 5.13%,were significantly lower than the control group 12.5 %,16.25% and 15% （P0.05）.Conclusion The reasonable dietary guidance with health education can control the mother＇s blood sugar,reduce macrosomia,premature birth and other adverse pregnancy outcomes.