评估早期个体化营养干预对妊娠期糖尿病孕妇血糖及并发症控制的影响

Evaluation of Influence of Early Individualized Nutrition Intervention for Control of Blood Sugar and Complications in Pregnant Women with Gestational Diabetes Mellitus

目的探讨妊娠期糖尿病患者接受早期个体化营养干预后血糖水平变化情况,以及对并发症、妊娠结局的影响。方法于该院门诊2017年1月-2019年1月期间内接收的妊娠期糖尿病咨询患者中方便选取108例,采用随机数字表法进行分组,观察组54例、对照组54例。对照组接受常规干预,观察组接受早期个体化营养干预。对比两组干预前后血糖水平变化情况,并观察患者干预后并发症发生情况、妊娠结局以及新生儿结局。结果观察组患者干预后FBG、PBG、Hb A1c水平为(5.09±1.25)mmol/L、(7.01±1.54)mmol/L、(4.05±1.23)%,均低于对照组(5.82±1.03)mmol/L、(7.69±1.63)mmol/L、(5.71±1.56)%,差异有统计学意义﹙t=3.312、2.228、6.140,P<0.05﹚;观察组患者干预后总并发症发生率是7.40%低于对照组18.52%,差异有统计学意义﹙χ^2=5.481,P<0.05﹚,且观察组阴道顺产率96.30%高于对照组79.63%、剖宫产率3.70%低于对照组20.37%,差异有统计学意义﹙χ^2=13.125,P<0.05﹚;观察组新生儿胎儿宫内窘迫、新生儿窒息、先天性心脏病发生率为1.85%、3.70%、1.85%,均都低于对照组11.11%、14.81%、9.26%﹙χ^2=7.075、7.348、5.233,P<0.05﹚。结论妊娠期糖尿病患者接受早期个体化营养干预效果确切,可有效降低血糖水平,间接改善妊娠结局,降低并发症发生几率以及新生儿不良事件发生几率,预后价值显著。

Objective To probe into the influence of early individualized nutrition intervention for control of blood sugar level and complications,pregnancy outcomes in pregnant women with gestational diabetes mellitus.Methods Convenient selection of 108 cases of patients with gestational diabetes mellitus and who received in our hospital of Outpatient Department from January 2017 to January2019 were randomly divided into control group and observation group,with 54 cases in each group.The control group were received routine intervention,while the observation group were received early individualized nutrition intervention.Then,the changes of blood sugar levels before and after intervention were compared between the two groups,and the complications,pregnancy outcomes and neonatal outcomes after intervention were observed.Results The levels of FBG,PBG and HbA1 c in the observation group after intervention were(5.09±1.25)mmol/L,(7.01±1.54)mmol/L,(4.05±1.23)%,respectively,which was lower than those in the control group of(5.82±1.03)mmol/L,(7.69±1.63)mmol/L,(5.71±1.56)%,the difference was statistically significant﹙t=3.312,2.228,6.140,P<0.05﹚.The incidence of total complications in the observation group was 7.40%,which was lower than that in the control group of 18.52%,the difference was statistically significant﹙χ^2=5.481,P<0.05﹚,and the vaginal spontaneous rate was96.30%,which was higher than that in the control group of 79.63%,and the cesarean section rate was3.70%,which was lower than that in the control group of20.37%,the difference was statistically significant﹙χ^2=13.125,P<0.05﹚.The incidence of fetal distress,neonatal asphyxia and congenital heart disease in the observation group were 1.85%,3.70%,1.85%respectively,which was lower than that in the control group of 11.11%,14.81%,9.26%,the difference was statistically significant﹙χ^2=7.075,7.348,5.233,P<0.05﹚.Conclusion The effects of early individualized nutrition intervention in patients with gestational diabetes mellitus are exact,which can effectively reduce blood sugar level,indirectly improve pregnancy outcomes,reduce the incidence of complications and adverse neonatal events,thus it has significant prognostic value.