早期个体化营养干预对妊娠期糖尿病孕妇血糖及并发症控制的影响

Effect of early individual nutrition intervention on blood glucose and control of complications in pregnant women with gestational diabetes mellitus

目的分析早期个体化营养干预对妊娠期糖尿病(GDM)孕妇血糖及并发症控制的作用。方法选取门诊治疗的GDM患者586例,其中425例接受个体化营养干预孕妇为观察组,161例接受普通营养干预孕妇为对照组,干预4周后比较两组患者饮食干预前、后餐后2 h血糖情况,并记录产妇并发症及剖宫产发生率情况。结果营养干预前,观察组患者与对照组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖及晚餐后2 h血糖差异均无统计学意义(P>0.05)。干预后,观察组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖及晚餐后2 h血糖水平均降低;对照组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖降低,晚餐后2 h血糖水平无改善;观察组患者干预后的血糖水平均低于对照组,差异有统计学意义(P<0.05)。饮食干预后,观察组患者妊娠期高血压、产后出血、胎膜早破及感染的发病率均低于对照组患者,差异有统计学意义(P<0.05)。观察组剖宫产率15.53%显著低于对照组剖宫产率30.43%,差异有统计学意义(P<0.01)。结论个体化营养干预能够有效控制妊娠期糖尿病孕妇的血糖稳定,达到降低孕产妇围产期并发症的作用,值得临床推广应用。

Objective To analyze the effect of early individual nutrition intervention on blood glucose and control of complications in pregnant women with gestational diabetes mellitus （GDM） . Methods A total of 586 patients with GDM treated in the hospital were select- ed, then they were divided into observation group （including 425 patients receiving early individual nutrition intervention） and control group （ including 161 patients receiving general nutrition intervention） . After four weeks, 2-hour postprandial blood glucose levels before and af- ter intervention in the two groups were compared. The incidence rates of complications and cesarean section rates were recorded. Results Before intervention, there was no statistically significant difference in fasting blood glucose, 2-hour postprandial blood glucose lev- els after breakfast, lunch, and supper between the two groups （P〉0. 05） . After intervention, fasting blood glucose, 2-hour postprandial blood glucose levels after breakfast, lunch, and supper in observation group decreased ; fasting blood glucose, 2-hour postprandial blood glu- cose levels after breakfast, lunch, and supper in control group didn＇t change; blood glucose levels in observation group were statistically sig- nificantly lower than those in control group （ P〈0. 05 ） . After intervention, the incidence rates of hypertensive disorder complicating preg- nancy, postpartum hemorrhage, premature rupture of fetal membranes, and infection in observation group were statistically significantly lower than those in control group （P〈0. 05） . The rate of cesarean section in observation group was 15.53%, which was statistically significantly lower than that in control group （ 30.43 % ） （ P〈0.01 ） . Conclusion Individualized nutrition intervention can effectively control blood glu- cose of pregnant women with GDM, which can reduce perinatal complications and deserve clinical application.