基础-餐时胰岛素治疗糖尿病合并妊娠临床效果及其对妊娠结局影响分析

Clinical Effect of Basic-Meal Insulin Therapy for Diabetes with Pregnancy and Its Effect on Pregnancy Outcome

目的研究基础-餐时胰岛素治疗糖尿病合并妊娠临床观察及其对妊娠结局影响。方法选择2017年6月—2018年8月在陵城区人民医院产科收治的糖尿病合并妊娠患者作为本次研究病人或研究对象,并采用“电脑随机法”将100例糖尿病合并妊娠患者进行分组,主要包括两组,其中观察组、实施基础-餐时胰岛素治疗;对照组、实施常规治疗,分析两组血糖指标变化、妊娠结局和降糖情况。结果观察组糖尿病合并妊娠患者空腹血糖(4.21±1.09)mmol/L、餐后2h血糖(6.43±1.34)mmol/L、糖化血红蛋白(5.12±1.04)%均低于对照组(t=5.35、2.59、6.51;P<0.05),两者差异有统计学意义(P<0.05)。观察组糖尿病合并妊娠患者早产所占比2.00%、产后出血和感染所占比0.00%、娠期高血压所占比2.00%、死产所占比0.00%,妊娠结局较对照组指标更有优势(χ^2=17.42;P<0.05)。观察组糖尿病合并妊娠患者血糖达标用时(5.32±1.09)d短于对照组、胰岛素日使用量(37.97±1.25)U/d少于对照组,差异有统计学意义(t=12.93、17.57;P<0.05)。结论基础-餐时胰岛素治疗糖尿病合并妊娠具有较好效果,能够使其血糖水平得到改善,同时改善患者妊娠结局,值得研究。

Objective To study the clinical observation of basic-meal insulin in the treatment of diabetes mellitus complicated with pregnancy and its effect on pregnancy outcome. Methods Patients with diabetes mellitus who were admitted to the obstetrics department of Lingcheng District People's Hospital from June 2017 to August 2018 were selected. And 100 patients with diabetes and pregnancy were divided by computer randomization method into observation group,(with implementation of basic-meal insulin therapy) and control group (with routine treatment). Changes in blood glucose levels, pregnancy outcomes and hypoglycemia were analyzed. Results In the observation group, fasting blood glucose was (4.21±1.09) mmol/L, postprandial 2h blood glucose was (6.43±1.34) mmol/L, and glycosylated hemoglobin was (5.12±1.04)%, which were lower than those in the control group (t=5.35, 2.59, 6.51;P <0.05), the difference between the two groups was statistically significant. In the observation group, the proportion of premature labor in the diabetic patients with pregnancy was 2.00%, the ratio of postpartum hemorrhage and infection was 0.00%, the proportion of hypertensive hypertension was 2.00%, and the ratio of stillbirth was 0.00%. The pregnancy outcome was better than the control group (χ^2= 17.42;P < 0.05). In the observation group, the blood glucose level of patients with diabetes and pregnancy was (5.32±1.09) d, which was shorter than that of the control group. And the daily insulin consumption (37.97±1.25) U/d was less than that of the control group, the difference was statistically significant (t=12.93, 17.57;P<0.05). Conclusion Base-meal insulin therapy for diabetes mellitus complicated with pregnancy has a good effect, which can improve blood sugar level, and the pregnancy outcomes of patients. It is worth learning.