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妊娠糖尿病患者加用胰岛素的时机对治疗效果及妊娠结局的影响 被引量:1

Effect of timing of insulin administration on treatment effect and pregnancy outcome in patients with gestational diabetes mellitus
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摘要 目的分析妊娠糖尿病患者加用胰岛素的时机对治疗效果及妊娠结局的影响。方法回顾性分析2016年12月至2017年12月我院接收并在妊娠32周后加用胰岛素诊治的妊娠糖尿病患者65例,设为A组。同期我院接收并在妊娠32周前加用胰岛素诊治的妊娠糖尿病患者65例,设为B组。比较两组空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)、血糖达标时间、胰岛素用量、子宫动脉血液流动学指标包括搏动指数(PI)、脐动脉阻力指数(RI)、妊娠并发症、妊娠结局、新生儿并发症及新生儿结局。结果治疗后,两组患者FBG、2 h PBG和HbA1c水平均明显低于治疗前,且B组明显低于A组(P<0.05)。治疗后,B组血糖达标时间明显短于A组,胰岛素用量明显少于A组(P<0.05)。治疗后,两组患者PI、RI均减小,且B组明显小于A组(P<0.05)。B组患者妊娠并发症发生率、妊娠结局均明显优于A组(P<0.05)。B组新生儿并发症发生率、新生儿结局均明显优于A组(P<0.05)。结论妊娠32周前加用胰岛素治疗妊娠糖尿病患者的临床效果更加显著,可推广应用。 Objective To analyze the effect of timing of insulin administration on treatment effect and pregnancy outcome in patients with gestational diabetes mellitus.Methods From December 2016 to December 2017,65 patients with gestational diabetes received in our hospital and treated with insulin after 32 weeks of gestation were analyzed retrospectively and set up as group A.At the same time,65 patients with gestational diabetes received in our hospital and treated with insulin before 32 weeks of gestation were set up as group B.The fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),the time of blood glucose reaching the standard,insulin dosage,uterine artery blood flow indexes including pulsation index(PI),umbilical artery resistance index(RI),pregnancy complications,pregnancy outcome,neonatal complications and neonatal outcome were compared between the two groups.Results After treatment,the levels of FBG,2 h PBG and HbA1c in the two groups were significantly lower than those before treatment,and those in the group B were significantly lower than the group A(P<0.05).After treatment,the time of blood glucose reaching standard in the group B was significantly shorter than that in the group A,and the dosage of insulin was significantly less than that in the group A(P<0.05).After treatment,PI and RI decreased in both groups,and those of the group B were significantly smaller than the group A(P<0.05).The incidences of pregnancy complications and pregnancy outcome in the group B were significantly better than those in the group A(P<0.05).The incidences of neonatal complications and neonatal outcome in the group B were significantly better than those in the group A(P<0.05).Conclusion Adding insulin to patients with gestational diabetes before 32 weeks gestation has a more significant clinical effect and can be widely used.
作者 王丽丽 雷瑞芸 WANG Li-li;LEI Rui-yun(Shangluo Central Hospital,Shangluo 726000,China)
机构地区 商洛市中心医院
出处 《临床医学研究与实践》 2020年第7期43-45,共3页 Clinical Research and Practice
关键词 妊娠糖尿病 胰岛素 治疗时机 妊娠结局 gestational diabetes mellitus insulin treatment opportunity pregnancy outcome
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