150例妊娠期糖尿病的临床观察

Clinical observation of 150 patients with gestational diabetes mellitus

目的：研究妊娠期糖尿病（GDM）筛查及早期干预对母婴的影响。方法：选择2008年11月~2010年11月,我院入院时OGTT试验确诊为GDM的患者150例,将其中进行早期筛查并干预良好的103例作为干预组,将24周以后确诊不遵循饮食治疗方案或34周以后确诊且血糖控制效果不佳的47例作为对照组。回顾性分析两组孕产妇妊娠结局及围生儿并发症等资料。结果：干预组与对照组妊娠结局比较发现,干预组妊娠期高血压、子痫前期、羊水过多、剖宫产、胎膜早破、酮症酸中毒的发生率均低于对照组,两组比较,差异均有高度统计学意义（均P〈0.01）。两组围生儿并发症比较,干预组死胎、巨大儿、早产儿、新生儿低血糖、呼吸窘迫综合征、高胆红血素的发生率均低于对照组,两组比较,差异均有统计学意义（P〈0.01、P〈0.05）。结论：对孕妇常规进行早期的妊娠期糖尿病筛查,并进行相关的健康教育行为干预,可以显著降低妊娠期高血压发生率、子痫前期风险等不良妊娠结局的发生率,以及围生儿并发症发生率。

Objective：To investigate the clinical significance of screening and early stage intervene in influencing patients with gestation diabetes mellitus（GDM） and their babies.Methods：150 cases of patients with GDM definitely diagnosed by OGTT in our hospital from November 2008 to November 2010 were selected.137 cases which had early stage screening and satisfactory intervene results were selected as intervention group,while 47 cases which had screening 24 weeks after being as pregnant or definitely diagnosed after 34 weeks with poor blood glucose control effect were selected as control group.Then retrospectively analyzed the maternal pregnancy consequences and babies＇ complication diseases.Results：There were significant differences between the intervention group and control group in pregnancy outcome such as gestation hypertension,preeclampsia,polyhydramnios,cesarean section,premature rupture of fetal membranes,ketoacidosis（all P 0.01）.And there were significant differences between the intervention group and control group in perinatal complications in children such as macrosomia,premature infants,neonatal hypoglycemia,neonatal respiratory distress syndrome,neonatal hyperbilirubinemia（P0.01,P0.05）.Conclusion：Early stage screening and effective intervention can definitely contribute to reducing the incidence rate of bad maternal pregnancy consequences and babies＇ complication diseases.