妊娠期糖尿病患者孕期血糖控制对妊娠结局的影响

Effect of blood glucose control during pregnancy on pregnancy outcomes on patients with gestational diabetes mellitus

目的探讨妊娠期糖尿病患者孕期血糖控制对妊娠结局的影响。方法选取2015年1月1日至2017年12月31日我院收治的妊娠期糖尿病患者100例,给予糖尿病健康知识宣传教育,使其养成合理膳食、适量运动、充分睡眠、心理平衡的健康生活行为习惯。对于病情较为严重者,根据血糖水平与患者意愿酌情给予适量注射胰岛素治疗。每周监测一次血糖,根据患者分娩前2次的血糖水平判断血糖控制效果。根据血糖控制效果将患者分为控制满意组(67例)与控制不满意组(33例),比较两组患者的并发症与不良妊娠结局的发生情况。结果血糖控制满意组患者的妊娠高血压、酮症、产后出血、围产期感染等并发症发生率(14.93%)明显低于血糖控制不满意组(42.42%),差异有统计学意义(P<0.05)。血糖控制满意组患者的早产、新生儿低血糖、胎儿窘迫、胎儿生长受限、巨大儿、死胎等不良妊娠结局的发生率(14.93%)明显低于血糖控制不满意组(54.55%),差异有统计学意义(P<0.05)。结论良好控制妊娠期糖尿病患者血糖水平,可明显降低其并发症与不良妊娠结局的发生风险。

Objective To investigate the effect of blood glucose control during pregnancy on pregnancy outcomes on patients with gestational diabetes mellitus.Methods A total of 100 patients with gestational diabetes mellitus admitted to our hospital from January 1,2015 to December 31,2017 were selected and received health education on diabetes mellitus,so as to develop healthy behavioral habits including reasonable diet,moderate exercise,adequate sleep and psychological balance.On patients with severe disease,appropriate doses of insulin were given according to the blood glucose level and the patients′ wishes.The blood glucose was monitored once a week,and the blood glucose control effect was evaluated based on the blood glucose levels of the last two times before delivery.According to the effect of blood glucose control,the patients were divided into control satisfied group (67 cases) and control unsatisfied group (33 cases),and the incidences of complications and adverse pregnancy outcomes between the two groups were compared.Results The incidence of complications including pregnancy-induced hypertension,ketosis,postpartum hemorrhage and perinatal infection in the control satisfied group(14.93%) was significantly lower than those of the control unsatisfied group (42.42%),and the difference was statistically significant ( P <0.05).The incidence of adverse pregnancy outcomes including premature delivery,neonatal hypoglycemia,fetal distress,fetal growth restriction,macrosomia and stillbirth in the control satisfied group(14.93%) was significantly lower than those of the control unsatisfied group(54.55%),and the difference was statistically significant ( P <0.05).Conclusions Good blood glucose control on patients with gestational diabetes mellitus can significantly reduce the risk of incidences of complications and adverse pregnancy outcomes.