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

Effect of additional insulin at different stages on pregnancy outcome of pregnant women with gestational diabetes mellitus

目的观察不同时期加用胰岛素对妊娠合并糖尿病(GDM)孕产妇妊娠结局的影响。方法选择在我院妇产科立卡的未采取胰岛素控制的179例GDM孕产妇为研究对象,以孕周32周为界限,将孕周在32周内的96例设为早期组,孕周在32周及以上的83例设为晚期组,两组均给予诺和灵R短效性胰岛素治疗。比较两组的血糖控制情况及妊娠结局。结果产前,两组空腹及餐后2 h血糖水平均显著降低,且早期组明显低于晚期组(P<0.05);早期组血糖控制达标率明显高于晚期组(P<0.05)。早期组剖宫产率、早产率均低于晚期组,顺产率高于晚期组(P<0.05)。结论孕早期加用胰岛素对GDM孕产妇的血糖控制效果理想,可明显提高血糖控制达标率,降低剖宫产率及早产率。

Objective To observe the effect of additional insulin at different stages on pregnancy outcome of pregnant women with gestational diabetes mellitus(GDM).Methods A total of 179 pregnant women with GDM who did not take insulin control in obstetrics and gynecology department of our hospital were selected as study objects.The 32 gestational weeks was used as the limit,ninety-six cases within 32 gestational weeks were set as early group and 83 cases at 32 gestational weeks and over were set as late group.Both groups were given Novolin R short-acting insulin therapy.The blood sugar control and pregnancy outcome were compared between the two groups.Results Before delivery,the levels of fasting and 2 h postprandial blood sugar in both groups significantly decreased,and those in the early group were significantly lower than the late group(P<0.05);the achievement rate of blood sugar control in the early group was significantly higher than that in the late group(P<0.05).The cesarean section rate and premature delivery rate in the early group were lower than those in the late group,and the spontaneous delivery rate was higher than that in the late group(P<0.05).Conclusion The additional insulin at early pregnancy on blood glucose control for pregnant women with GDM has ideal effect,which can significantly improve the achievement rate of blood sugar control,decrease the rate of cesarean section and premature delivery.