妊娠合并糖尿病的诊治时机、方法与围产儿预后的关系分析

Analysis of the Relationship between the Time and Method of Diagnosis and Prognosis of Pregnancy in Gestational Diabetes Mellitus

目的探讨妊娠合并糖尿病患者的诊治时机、方法与围产儿预后的关系。方法选取2016年8月-2017年8月期间河南省新乡市妇幼保健院50例妊娠前半期(孕周≤20周)诊断的妊娠合并糖尿病患者,作为A组;选取同期50例妊娠后半期(孕周>20周)诊断的妊娠合并糖尿病患者,作为B组。回顾性分析A组、B组围产儿预后。将两组100例患者根据治疗方式、效果分为C组(饮食、运动干预后降糖效果理想,n=71)、D组(饮食、运动联合胰岛素治疗后降糖效果理想,n=17)、E组(血糖控制不理想,n=12)。观察各组围产儿预后。结果①A组巨大儿、小儿畸形、小儿低血糖发生率均低于B组(P<0.05)。②E组巨大儿、小儿畸形、小儿低血糖发生率均高于C组、D组(P<0.05),但C组、D组之间差异无统计学意义(P>0.05)。结论妊娠合并糖尿病患者早期诊治有利于改善围产儿预后,需引起高度关注。

Objective To investigate the relationship between the time and methods of diagnosis and prognosis of pregnancy in Gestational diabetes mellitus. Methods A total of 50 cases of the former half of the pregnancy period (gestational weeks ≤ 20 weeks) diagnosed as gestational diabetes mellitus in the hospital from August 2016 to August 2017 were selected as group A. 50 cases of the latter half of the pregnancy period (gestational weeks > 20 weeks) diagnosed as gestational diabetes mellitus were selected as group B. The prognosis of perinatal infants in group A and group B was retrospectively analyzed. According to the treatment mode and effect, 100 patients in the two groups were divided into group C (improved hypoglycemic effect after diet and exercise intervention, n=71), group D (improved hypoglycemic effect after diet and exercise combined with insulin therapy, n=17), group E (blood sugar control is not ideal, n=12). The prognosis of perinatal infants in each group was observed. Results The incidence of macrosomia, infantile deformity, infantile hypoglycemia in children in group A was lower than those in group B (P < 0.05). The incidence of macrosomia, infantile deformity, infantile hypoglycemia in children in group E were higher than those in group C and D (P < 0.05), but there was no significant difference between group C and group D (P > 0.05). Conclusion Early diagnosis and treatment of gestational diabetes mellitus is beneficial to improve the prognosis of perinatal children and needs to be highly concerned.