妊娠合并糖尿病患者胰岛素治疗起始孕周与妊娠结局的关系研究

Research on Relationship between the Initiative Pregnant Week and Preg-nant Outcome of Insulin Treatment for Patients with Pregnancy and Dia-betes

目的探究妊娠合并糖尿病患者胰岛素治疗起始孕周与妊娠结局之间的关系。方法对2013年1月—2015年1月使用胰岛素治疗妊娠合并糖尿病患者350例资料进行回顾性分析,依照使用胰岛素孕周,分为早期组(1组)182例与晚期组(2组)168例。以饮食控制为基础,使用胰岛素治疗,比较治疗前后餐后2 h血糖值与空腹血糖值,生产结局与不良反应发生率。结果经治疗之后,两组受试者的血糖值均在标准范围之内,在入院时,两组患者的餐后与空腹血糖差异无统计学意义(P>0.05),且在分娩之前,患者两种血糖水平均比入院时高(P<0.05)。和2组相比,1组患者的胎儿窘迫以及巨大儿发生率显著较低(P<0.05),在死胎、早产率、剖宫产率方面两组受试者差异无统计学意义(P>0.05)。结论对于妊娠合并糖尿病者,以常规饮食控制为基础,在孕早期使用短效胰岛素加以治疗,可取得满意效果,全面改善妊娠结局,值得进一步推广。

Objective To research the relationship between the initiative pregnant week and pregnant outcome of insulin treatment for patients with pregnancy and diabetes. Methods The data of 350 cases of patients with pregnancy and diabetes treated with insulin from January 2013 to January 2015 were retrospectively analyzed, and the patients were divided into the group 1 with 182 cases and group 2 with 168 cases according to the pregnant week, and the insulin was used for treatment based on the dieting control, and the 2-hour？postprandial blood sugar, fasting blood sugar, birth outcome and incidence rate of adverse reactions were compared before and after treatment. Results After treatment, the blood sugar value of the two groups was within the standardized range, on admission, there was no obvious difference in the postprandial and fasting blood sugar between the two groups（P〉0.05）, before delivery, the two blood sugar levels of patients were higher than those on admission（P〈0.05）. The incidence rate of intrauterine asphyxia and giant baby in the group 1 was obviously lower than that in the group 2（P〈0.05）, and there was no obvious difference in the stillborn foetus, premature birth rate and cesarean delivery rate（P〉0.05）. Conclusion For patients with pregnancy and diabetes, the use of short-acting？insulin for treatment in the early pregnancy period can obtain a satisfactory effect and can comprehensively improve the pregnant outcome, which is worth further promotion.