孕期不同时期的综合管理对妊娠期糖尿病患者血糖及妊娠结局的影响效果分析

Effect of comprehensive management in different periods of pregnancy on blood glucose and pregnancy outcome in patients with gestational diabetes mellitus

目的观察孕期不同时期的综合管理对妊娠期糖尿病患者血糖及妊娠结局的影响效果,探讨适宜的血糖管理时间。方法选择我科2015年2月～2017年2月收治的120例妊娠期糖尿病患者,根据开始血糖管理的不同时期进行观察组的分组,其中孕周<28周者为早期干预组(早期组)60例,孕周在28～36周者为中期干预组(中期组)30例,孕周> 36周者为晚期干预组(晚期组)30例,以30例未行任何血糖管理的孕产妇作为对照组,观察各组孕产妇血糖控制情况以及对于妊娠结局的影响。结果与对照组比较,观察组的早期组、中期组与晚期组的血糖控制良好率均升高明显,血红蛋白水平以及妊高症、羊水过多、剖宫产的比例、巨大儿、新生儿窒息与新生儿低血糖均降低明显,差异有统计学意义(P <0.05)。观察组组内比较,与晚期组比较,早期组、中期组的血糖控制良好率均升高明显,血红蛋白水平、妊高症、剖宫产以及巨大儿、新生儿窒息与新生儿低血糖的比例均降低明显,差异有统计学意义(P <0.05);与中期组比较,早期组的血糖控制良好率升高明显,血红蛋白水平、妊高症、羊水过多、剖宫产以及巨大儿、新生儿窒息与新生儿低血糖的比例均降低明显,差异有统计学意义(P <0.05)。结论孕早期进行综合管理可较好的控制妊娠期糖尿病患者血糖,降低孕产妇及新生儿并发症,确保母婴安全。

Objective To observe the effect of comprehensive management in different periods of pregnancy on blood glucose and pregnancy outcome in patients with gestational diabetes mellitus,and to explore the suitable time for blood glucose management.Methods One hundred and twenty patients with gestational diabetes mellitus who were treated in our department from February2015to February2017were selected and divided the observation group into groups by different periods of blood glucose management,the gestational age<28weeks was the early intervention group(early group)-60cases,the gestational age between28-36weeks was the mid-term intervention group(middle group)-30cases,the gestational age>36weeks was the late intervention group(late group)-30cases.Thirty pregnant women who did not have any blood glucose management were selected as the control group.The blood glucose control and the effect on pregnancy outcomes of each group were observed.Results Compared with the control group,the good rate of blood glucose control of the observation group increased more significantly,hemoglobin level and pregnancy-induced hypertension,polyhydramnios,the proportion of cesarean section,macrosomia,neonatal asphyxia and neonatal hypoglycemia decreased more significantly,the differences were statistically significant(P<0.05).Compared within the observation group,the good rate of blood glucose control in the early group and the middle group increased more significantly than the late group,and hemoglobin level,pregnancy-induced hypertension,cesarean section,and the proportion of macrosomia,neonatal asphyxia and neonatal hypoglycemia decreased more significantly,the difference was statistically significant(P<0.05).Compared with the middle group,the good rate of blood glucose control in the early group increased more significantly,and the hemoglobin level,pregnancy induced hypertension,polyhydramnios,cesarean section and the proportion of macrosomia,neonatal asphyxia and neonatal hypoglycemia decreased more significantly,the difference was statistically significant(P<0.05).Conclusion Comprehensive management in early pregnancy can better control the blood glucose of patients with gestational diabetes mellitus,reduce the complications and ensure the safety of mothers and infants.