浅谈不同时期加用胰岛素对妊娠合并糖尿病孕产妇妊娠结局的影响

Analysis of Effect of Adding Insulin on the Gestational Outcome of Maternal Women with Gestation Combined with Diabetes in Different Periods

目的对妊娠合并糖尿病孕产妇不同时期使用胰岛素治疗后妊娠结局受到的影响情况进行探讨分析。方法该院2016年6月—2017年6月间对妊娠合并糖尿病孕产妇150例开展了分析研究,根据不同的胰岛素给药时间来进行分组,前期组80例在孕周小于32周时用药,后期组70例在孕周超过32周时用药,使用的剂量根据孕产妇的情况调整,对两组的血糖情况、并发症情况和新生儿进行比较。结果经过治疗,前期组孕产妇的空腹血糖平均是(5.31±0.61)mmol/L、餐后2 h血糖是(7.16±0.84)mmol/L,后期组分别是(5.82±0.52)、(7.77±0.91)mmol/L,两组的结果对比差异有统计学意义(P<0.05)。前期组的高血压、死产、产后出血和感染情况均比后期组低,剖宫产率比后期组高,新生儿并发症发生率比后期组低(P<0.05)。结论在孕32周前对妊娠合并糖尿病孕妇进行治疗可显著控制孕产妇血糖,同时可显著改善妊娠并发症及新生儿并发症的发生情况;对妊娠合并糖尿病孕产妇应做到早发现,早治疗。

Objective To study and analyze the effect of adding insulin on the gestational outcome of maternal women with gestation combined with diabetes in different periods. Methods From June 2016 to June 207 150 cases of maternal women with gestation combined with diabetes in our hospital were selected and divided into two groups according to different insulin administration time, the pre-stage group with 80 cases used the drugs when the gestation week 32, and the late-stage group with 70 cases used the drugs when the gestation week 32, and the dosage was adjusted according to the conditions of maternal women, and the blood glucose, complications and newborns were compared between the two groups. Results After treatment, the average fasting blood glucose level and postprandial 2 h blood glucose levels in the pre-stage group and in the late-stage group were respectively（5.31±0.61）mmol/L,（7.16±0.84）mmol/L and（5.82±0.52）mmol/L,（7.77±0.91）mmol/L,and the differences between groups were statistically significant（P〈0.05）. and the hypertension, dead-birth, postprandial postpartum and infection in the pre-stage group were lower than those in the late-stage group, and the cesarean section rate was higher than that in the late-stage group, and the incidence rate of complications of newborns was lower than that in the late-stage group（P〈0.05）. Conclusion The treatment for delivery women with gestation combined with diabetes before 32 weeks can obviously control the blood glucose and obviously improve the occurrence of gestation and complications, and we should do well in the early discovery and early treatment.