妊娠期糖尿病一日门诊管理模式对妊娠结局的影响

Effect of one-day outpatient management education mode on the pregnancy outcome of the patients with gestational diabetes mellitus

目的分析妊娠期糖尿病(GDM)一日门诊管理模式对孕妇血糖和妊娠结局的影响。方法选取2014年1月至2015年12月在我院进行产检、分娩且资料完整的1 914例GDM孕妇为研究对象,将其中采用GDM一日门诊管理模式干预的739例为观察组,采用GDM传统管理干预的1175为对照组。观察两组孕妇的血糖情况和妊娠结局。结果观察组孕妇的空腹及餐后2 h血糖均明显低于对照组(P<0.01),其新生儿正常体质量的出生率高于对照组(P<0.01),巨大胎和大于胎龄儿、小于胎龄儿和胎儿生长受限的发生率则低于对照组(P<0.01或0.05)。两组妊高症、羊水过多、羊水过少、产后出血、早产儿、胎儿窘迫及新生儿窒息发生率的差异无统计学意义(P>0.05)。结论 GDM一日门诊管理模式可以有效地控制孕妇血糖,降低巨大胎及大于胎龄儿、小于胎龄儿和胎儿生长受限的发生,改善母婴结局。

Objective To investigate the effect of one-day outpatient management education mode on the blood glucose and the pregnancy outcome of the patients with gestational diabetes mellitus （GDM）. Methods 1914 cases with GDM undergoing antenatal care and delivery from January 2014 to December 2015 in our hospital and with complete data were selected as objects, of which 739 cases receiving GDM one-day outpatient management were included in Observation Group while 1175 cases receiving traditional management were included in Control Group. The blood glucose and pregnancy outcome of the two groups were observed and compared. Results The fasting and 2h postprandial blood glucose in Observation Group was significantly lower than that of Control Group （P〈0.01）, the birth rate with normal neonatal birth weight in Observation Group was higher than that in Control Group （P〈0.01）, and the incidence of giant fetus, large gestational age infant, small gestational age infant and fetal growth restriction in Observation Group was lower than that in Control Group（P〈0.01或0.05）. There was no statistical difference in the incidence of pregnancy hypertension, polyhydramnios, oligohydramnios, postpartum hemorrhage, preterm infants, fetal distress and neonatal asphyxia between the two groups （P〉0.05）. Conclusion One-day outpatient management mode for GDM can effectively reduce the blood glucose of the patients with GDM and improve perinatal outcome.