196例妊娠期糖尿病临床分析

Clinical analysis on 196 cases of Gestational Diabetes

目的探讨孕中期检查发现妊娠糖尿病且血糖控制良好者与孕晚期血糖控制不佳或产后诊断为妊娠糖尿病者的母婴结局分析。方法选择徐州市妇幼保健院2013年1月至2014年6月分娩妊娠期糖尿病196例产妇为研究对象,其中100例患者在孕24~28周内检出妊娠糖尿病,积极采取皮下注射胰岛素、饮食控制等方案,将血糖控制在满意范围内,分为研究组;96例为孕晚期血糖控制不佳或产后诊断为妊娠糖尿病孕妇,分为对照组,对两组产妇生产方式,妊娠结局情况进行观察。结果研究组胎儿窘迫、新生儿窒息、先天性疾病发生率显著低于对照组（P〈0.05）;研究组剖宫产率为21.00%,顺产率79.00%,对照组剖宫产率为58.33%,顺产率为41.67%,两组有明显差异（P〈0.05）;研究组产后出血量、羊水量较对照组低,Apgar评分较对照组高、新生儿体重较接近正常,差异存在统计学意义（P〈0.05）。结论妊娠期糖尿病孕产妇必须严格控制血糖,可有效改善母婴结局,降低剖宫产率,确保母婴安全。

Objective To investigate the maternal and neonatal outcomes between well glycemic control patients with Gestational Diabetes diagnosed in second trimester examination and poor glycemic control patients in third trimester or gestational diabetes patients at postnatal diagnosis. Methods Selected 196 lying-in women from MCH, Xuzhou city from January 2013 to June 2014 as study objects. 100 of them was diagnosed Gestational Diabetes at 24 to 28 weeks pregnant and were actively taken subcutaneous insulin, diet and so on to control the blood sugar in a Satisfactory range, these 100 patients classified as research group; 96 patients were poor glycemic control patients in third trimester or gestational diabetes patients at postnatal diagnosis, these 96 patients were classified as control group. Observed the two groups＂ mode of production and pregnancy outcome. Results The research groups＂ fetal distress, asphyxia and the incidence of congenital were all obvious lower than the control group（P 〈0. 05） ; the research group＇s cesarean section rate was 21.00% and the natural production was 79. 00% ; the control group~ cesarean section rate was 58.33% and the Natural production was 41.67%, there was a obvious difference between these two groups （ P 〈 0. 05 ） ; the research group＇s Postpartum hemorrhage and Amniotic fluid volume were both obvious lower than control group, but its Apgar score was higher than the control group and the neonatal＇s weight was more closer to normal, the differences have statistic significance （P 〈 0. 05 ）. Conclusions Gestational diabetes maternal should strictly control their blood sugar, which can effectively improve maternal and neonatal outcomes, decrease cesarean section rate to ensure the maternal and children＇s security.