缩短禁食禁饮时间对妊娠期糖尿病产妇分娩结局的影响

Effects of shortening fasting and no-drinking time on the outcome of pregnant women with gestational diabetes undergoing cesarean section

目的研究缩短禁食禁饮时间对妊娠期糖尿病(gestational diabetes mellitus,GDM)产妇分娩结局的影响。方法纳入笔者所在医院2018年5月-2019年5月收治的行剖宫产术的GDM产妇90例进行研究,将其随机分成干预组和对照组,各45例。对照组实施常规禁食禁饮处理,即术前禁食8 h,禁饮6 h。干预组则适当缩短禁食禁饮时间,即术前禁食6 h,禁饮2 h。比较2组围术期相关指标水平、不良妊娠结局发生情况、产妇术前不适反应发生情况、产妇满意度情况。结果干预组术前血糖水平及满意率显著高于对照组(t=3.136,P=0.002;χ^(2)=4.050,P=0.044),而术后24 h出血量、新生儿低血糖发生率、产妇术前不适反应发生率均低于对照组(t=13.278,P<0.001;χ^(2)=6.049,P=0.014;χ^(2)=6.944,P=0.008)。结论减少禁食禁饮时间有利于改善GDM产妇的妊娠结局,减少其术前不适反应的发生,提高产妇满意率,值得临床推广应用。

Objective To explore the effect of shortening fasting and no-drinking time on the outcome of pregnant women with gestational diabetes mellitus(GDM).Methods Ninety GDM pregnant women admitted to our hospital between May 2018 and May 2019 were selected and divided into an intervention group and a control group,each of 45,according to the envelope method.The control group was forbidden to eat and drink 8 and 6 hours before the operation respectively,while the intervention group was asked to fast for 6 hours and not to drink 2 hours before the delivery.The levels of perioperative indicators,adverse pregnancy outcomes,preoperative discomfort and maternal satisfaction were compared between the two groups.Results The preoperative blood glucose and satisfaction of the intervention group was significantly higher than that of the control group(t=3.136,P=0.002;χ^(2)=4.050,P=0.044),while the postoperative 24-hour blood loss,as well as the incidence of neonatal hypoglycemia and preoperative discomfort of the former group was significantly lower than that of the control group(t=13.278,P<0.001;χ^(2)=6.049,P=0.014;χ^(2)=6.944,P=0.008).Conclusion Reducing the duration of fasting and abstinence from drinking improves the outcome of GDM pregnant women,which can reduce the occurrence of preoperative discomfort and improve the maternal satisfaction.Therefore,it is worthy of clinical application.