妊娠糖尿病规范管理与妊娠结局

Effect of standardized management of gestational diabetes mellitus on pregnancy outcomes

目的:探讨妊娠糖尿病(GDM)规范化管理的效果和妊娠结局的关系。方法:对56例GDM患者(研究组)进行规范管理,包括饮食调节、运动治疗、胰岛素治疗、糖尿病知识健康教育等;以1∶2比例选择同期该院非糖尿病孕妇112例作为对照。结果:①糖尿病相关知识知晓率由管理前的26.79%提高到管理后的85.71%,糖尿病对母儿危害的相关知识知晓率由管理前的10.71%提高到91.07%,P<0.01;②管理后血糖水平显著下降,自身对照P<0.01;③剖宫产、羊水过多发生率研究组高于正常对照组,P<0.01或P<0.05,妊高征、产后出血、产程延长、阴道助产、胎膜早破、巨大儿、新生儿高胆红素血症、新生儿呼吸窘迫综合征发生率组间比较差异无统计学意义,P>0.05。结论:①规范化管理可以使血糖良好控制,可提高孕妇对GDM相关知识的知晓率,提高管理依从性;②规范管理GDM孕妇可降低母儿并发症,获得与正常妊娠基本等同的妊娠结局。

ObjectiVe： To investigate the relationship between the standardized management on gestational diabetes mellitus （GDM） . and pregnancy outcomes. Methods： A total of 56 GDM women （study group） were performed standardized management, which was diet regulation, exercise, insulin therapy and diabetes education et al, and 112 cases non - diabetic pregnant women in our hospital during the same period were chosen by 1 ： 2 ratio as a control group. Results： （1）Awareness rates of knowledge about diabetes mellitus before mangement was 26. 79% and after management was 88. 71% , awareness rates of knowledge on impacts of gestational diabetes mellitus on maternal and fetal was 10. 71% before management and was 91. 07% after management. （2）Plasma glucose （PG） level was significantly lower than that before management, P 〈 0. 01. （3） The rates of abdominal delivery and hydramnion in study group were higher than that in control group, P 〈 0.01 or P 〈 0. 05. There were not significant differences in the rates of pregnancy induced hypertension syndrome, postpartum hemgrrhage, prolonged labor, assisted vaginal delivery, premature rupture of fetal membranes, macrosomia, neonatal hyperbilirubi- nemia, neonatal respiratory distress syndrome in the two groups （ P 〉 0. 05 ） . Conclusion： （1）Standardized management can ensure the well resuhs of controlling hyperglycemia, and make GDM women to get more knowledge of diabetes mellitus, and can improve their compliance under management; （2）Standardized management can reduce complications of maternal and fetal, and get the same pregnancy outcomes as non - diabetic pregnant women.