孕期系统化管理对妊娠糖尿病母婴结局的影响

Influence of pregnancy systematized management on the outcome of gestational diabetes mellitus

目的探讨孕期系统化管理对妊娠糖尿病母婴结局的影响。方法选择2000年2月～2011年12月首都医科大学附属北京世纪坛医院收治已确诊的妊娠期合并糖尿病患者154例,观察组78例实施孕期系统化管理,对照组76例未实施孕期系统化管理,对两组患者母婴结局进行分析比较。结果观察组8例孕妇经葡萄糖耐量试验检测,显性糖尿病患者4例,发病率为5.13%(4/78),而对照组76例患病孕妇产后糖耐量检测结果表明,显性糖尿病患者16例,发病率为21.05%(16/78),观察组产后母婴发病率明显低于对照组(P<0.05)。观察组孕期妊娠高血压综合征、剖宫产率、羊水过多、早产率、孕期感染及围生期新生儿体质状况均优于对照组,差异有统计学意义(P<0.05)。结论妊娠糖尿病产前予以个体性的综合系统化管理干预,对该症在孕期、围生期及产后并发症、患儿生存质量上有深远影响。

Objective To explore the influence of pregnancy systematized management on the outcome of gestational diabetes mellitus. Methods 154 cases diagnosed as gestational diabetes mellitus in Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2000 to December 2011 were chosen, 78 cases of the observation group were taken pregnancy systematic management, and the other 76 patients in the control group did not take the pregnancy systematic management, the outcomes of the two groups were analyzed and compared. Results After 78 cases of the observation group took the g!ucose tolerance test, the result showed that there were 4 cases of dominant diabetes, the incidence was 5.13% （4/78）, and after 76 cases of the control group took the glucose tolerance test, the result showed that there were 16 cases of dominant diabetes, the incidence was 21.05% （16/78）, postpartum maternal morbidity of observation group was significantly lower than the control group （/9 〈 0.05）. The uteruses pregnancy high sign, cutting palace rate, polyhydramnios, premature birth rate and pregnancy infection and the perinatal period neonatal physical condition of observation group were all superior to control group, the differences were statistically significant （P 〈 0.05）. Conclusion Individuality comprehensive systematic management intervention given in prenatal gestational diabetes has far-reaching influence for the disease in pregnancy, perinatal period and postpartum complications, quality of life.