妊娠期糖尿病的医学营养治疗疗效评价

Evaluation the Efficacy of Medical Nutrition Therapy on Gestational Diabetes Mellitus

目的:探讨医学营养治疗对妊娠期糖尿病(GDM)孕妇妊娠结局的影响。方法:将我院门诊产前检查确诊为GDM,并完成随访的孕妇分为医学营养治疗(MNT)组61例与非干预组60例。同时选择同期在我院分娩的正常孕妇作为正常对照组60例。比较3组的母儿并发症的发生率。结果:MNT组巨大儿、新生儿低血糖、新生儿住院、羊水过多发生率均低于非干预组,差异有统计学意义(P<0.05);两组妊娠期高血压疾病、胎膜早破、早产、胎儿窘迫、剖宫产、足月低体重儿(小于胎龄儿)、新生儿呼吸窘迫综合征(NRDS)发生率比较,差异无统计学意义(P>0.05)。非干预组巨大儿、新生儿低血糖、新生儿住院发生率均明显高于正常对照组(P<0.05),两组羊水过多、妊娠期高血压疾病、胎膜早破、早产、胎儿窘迫、剖宫产、足月低体重儿(小于胎龄儿)、NRDS发生率比较,差异无统计学意义(P>0.05)。MNT组与正常对照组比较,羊水过多、妊娠期高血压疾病、胎膜早破、早产、胎儿窘迫、剖宫产、巨大儿、足月低体重儿(小于胎龄儿)、新生儿低血糖、新生儿住院、NRDS发生率差异均无统计学意义(P>0.05)。结论:医学营养治疗可有效减少GDM围生期母儿并发症,有利于获得良好的母儿结局。

Objective：To investigate the effect of medical nutrition therapy on pregnancy outcomes in patients with gestational diabetes mellitus. Methods： 121 cases of GDM patients diagnosed by OG＇I-I- in our hospital were randomly divided into medical nutrition therapy group and non-intervention group. 60 cases with normal pregnancy were selected as control group. Maternal and fetal complications were compared among groups. Results：In medical nutrition therapy group,the rate of hydramnios, macrosomia, neonatal hypoglycemia and the incidence of neonatal hospitalization were significantly lower than those in non-intervention group （P 〈 0.05）. There was no significant difference in pregnancy-induced hypertension syndrome, premature rupture of membranes, preterm delivery,fetal distress, cesarean section rate,full-term low birth weight children（small for gestational age children）and neonatal respiratory distress（NRDS） between medical nutrition therapy group and non-intervention group（ P 〉 0.05）. In non-intervention group,the rate of macrosomia, neonatal hypoglycemia and the incidence of neonatal hospitalization were significantly higher than those in control group（P〈0. 05）. There was no significant difference in hydramnios, pregnancy-induced hypertension syndrome,premature rupture of membranes, preterm delivery, fetal distress, cesarean section rate, full-term low birth weight children（small for gestational age children）,and NRDS occurrence rate between non-intervention group and control group （ P 〉 0.05）. There was no significant difference in hydramnios, pregnancy-in- duced hypertension syndrome, premature rupture of membranes, preterm delivery, cesarean fetal distress, section rate, macrosomia,full-term low birth weight children（small for gestational age children）, NRDS occurrence rate, neonatal hypoglycemia and the incidence of neonatal hospitalization between medical nutrition therapy group and control group （ P 〉 0. 05）. Conclusions： Medical nutrition therapy can effectively reduce the perinatal complications of gestational diabetes, and promote maternal and neonatal outcomes.