妊娠期糖尿病患者行胰岛素注射治疗的孕周对治疗效果及妊娠结局的影响

Influence of gestational week of gestational diabetes mellitus patients treated with insulin injection on the therapeutic effect and pregnancy outcomes

目的分析妊娠期糖尿病患者行胰岛素注射治疗的孕周对治疗效果及妊娠结局的影响。方法选取我院2017年5月至2019年2月收治的106例妊娠期糖尿病患者为研究对象,根据患者接受药物治疗时间的不同将其分为对照组和观察组,每组53例。对照组患者接受胰岛素注射治疗的时间为孕周≥32周,观察组患者接受胰岛素注射治疗的时间为孕周<32周。比较两组患者的剖宫产、不良妊娠结局及低血糖的发生率、治疗前及分娩时的血糖水平。结果两组患者的剖宫产率比较,差异无统计学意义(P>0.05)。观察组早产、新生儿窒息、巨大儿及低血糖发生率均低于对照组(P<0.05)。分娩时,两组患者的空腹血糖和餐后2 h血糖水平均显著低于治疗前,且观察组低于对照组(P<0.05)。结论妊娠期糖尿病患者在孕32周前接受胰岛素注射治疗,可以有效降低患者的空腹血糖和餐后2 h血糖水平,并减少不良妊娠结局,值得临床推广应用。

Objective To analyze the influence of gestational week of gestational diabetes mellitus patients treated with insulin injection on the therapeutic effect and pregnancy outcomes. Methods One hundred and six patients with gestational diabetes mellitus admitted in our hospital from May 2017 to February 2019 were selected as the research objects.According to the time of drug treatment, the patients were divided into control group and observation group, with 53 cases in each group. The control group received insulin injection at gestational weeks ≥32 weeks, while the observation group received insulin injection at gestational weeks<32 weeks. The incidences of cesarean section, adverse pregnancy outcomes,hypoglycemia, blood glucose levels before treatment and during delivery were compared between the two groups. Results There was no significant difference in cesarean section rate between the two groups(P>0.05). The incidences of premature birth, neonatal asphyxia, macrosomia and hypoglycemia in the observation group were lower than those in the control group(P <0.05). At delivery, the levels of fasting blood glucose and 2 h postprandial blood glucose in the two groups were significantly lower than those before treatment, and those in the observation group were lower than the control group(P<0.05). Conclusion Patients with gestational diabetes mellitus receiving insulin injection before 32 weeks of gestation can effectively decrease the levels of fasting blood glucose and postprandial blood glucose, and reduce adverse pregnancy outcomes, which is worthy of clinical application.