妊娠合并糖尿病孕产妇不同时期加用胰岛素治疗对妊娠结局的影响

Effect of insulin treatment on pregnancy outcome in pregnant women with diabetes mellitus at different stages

目的 探讨妊娠合并糖尿病孕产妇不同时期加用胰岛素治疗对妊娠结局的影响.方法 对我院2016年2月至2017年2月收治的294例妊娠合并糖尿病的孕产妇进行研究,根据患者妊娠周期分为对照组（妊娠周期＞32周,共138例）和观察组（妊娠周期≤32周,共156例）.两组患者均在常规治疗的基础采用胰岛素进行治疗,比较两组患者的妊娠结局、血糖指标以及血流动力学变化.结果 观察组产妇巨大儿、新生儿窒息、死胎、胎儿窘迫等不良妊娠结局的发生率均显著低于对照组（P＜0.05）,观察组产妇分娩时空腹血糖值和餐后2 h血糖值均显著低于对照组（P＜0.05）;观察组产妇子宫血流动力学情况显著优于对照组,差异具有统计学意义（P＜0.05）.结论 妊娠合并糖尿病孕产妇在妊娠32周之前给予胰岛素治疗可有效改善患者血糖情况,缓解血流动力学变化,改善妊娠结局,值得临床推广.

Objective To explore the effect of insulin therapy on pregnancy outcome in pregnant women with gestational diabetes mellitus at different stages. Methods Two hundred and ninety-four pregnant women with diabetes mellitus were enrolled in our hospital from February 2016 to February 2017, and divided into control group （pregnancy cycle 〉32 weeks, 138 cases） and observation group （pregnancy cycle ≤32 weeks, a total of 156 cases）. Two groups of patients were treated with insulin on the basis of routine treatment, the pregnancy outcome, blood glucose indicators and hemodynamic changes of the two groups were compared. Results The incidence of adverse pregnancy outcomes including giant child, neonatal asphyxia, stillibirth and fetal distress were significantly lower in the observation group than that in the control group （P〈 0.05）. The fasting blood glucose and postprandial 2 h blood glucose in the observation group were significantly lower than those in the control group （P〈0.05）. The hemodynamies of maternal uterus in the observation group was significantly better than that in the control group （P〈0.05）. Conclusion Pregnancy with diabetes maternal pregnancy before 32 weeks receive insulin therapy can effectively improve the patient＇s blood sugar, relieve hemodynamic changes, improve the outcome of pregnancy, which is worthy of clinical promotion.