妊娠期糖尿病高危孕妇早期治疗临床研究

Study of early treatment of pregnant women with gestational diabetes mellitus with high risk factors

目的探讨早期治疗对高危妊娠期糖尿病(GDM)孕妇妊娠结局的影响。方法纳入2014年7月至2015年6月在我院规律产检直至分娩的高危GDM孕妇100例,按照随机数表法均分为两组(n=50),以孕28周为界,对照组孕28周后实施治疗,观察组28周前实施治疗,比较两组孕妇的分娩方式和妊娠结局。结果观察组孕妇的剖宫产率为20.0%(10/50),明显低于对照组的40.0%(20/50),差异有统计学意义(P<0.05);观察组孕妇合并妊娠高血压、胎膜早破、羊水过多、产后出血分别为2.0%(1/50)、4.0%(2/50)、6.0%(3/50)、4.0%(2/50),均显著低于对照组的10.0%(5/50)、16.0%(8/50)、16.0%(8/50)、12.0%(6/50),差异均有统计学意义(P<0.05);观察组早产率、巨大儿发生率分别为2.0%(1/50)、4.0%(2/50),均显著低于对照组的10.0%(5/50)、14.0%(7/50),差异均有统计学意义(P<0.05)。结论对于高危GDM孕妇,在孕28周前给予早期治疗可以显著降低产妇和新生儿并发症,改善妊娠结局。

Objective To discuss the effect of early treatment on the pregnancy outcome of pregnant women with gestational diabetes mellitus(GDM) with high risk factors. Methods A total of 100 cases of rules for check until delivery of high-risk pregnant women with GDM, who admitted into our hospital from August 2013 to August 2014,were selected and divided into two groups(n=50) according to the random number table. With pregnancy 28 weeks as boundary, patients received treatment after 28 weeks of pregnancy were enrolled as the control group, and those treated before 28 weeks of pregnancy were selected as the observation group. The mode of delivery and pregnancy outcomes of the two groups of pregnant women were recorded and compared. Results The cesarean section of the observation group 20.0%(10/50) was significantly lower than that of the control group 40.0%(20/50), P<0.05. The pregnancy hypertension, fetal membranes, premature rupture, polyhydramnios, postpartum hemorrhage of observation group [2.0%(1/50), 4.0%(2/50), 6.0%(3/50), 4.0%(2/50), respectively] were significantly lower than those of the control group [10.0%(5/50), 16.0%(8/50), 16.0%(8/50), 12.0%(6/50), respectively], P<0.05. The premature delivery rate and macrosomia incidence of the observation group [2.0%(1/50), 4.0%(2/50), respectively] were significantly lower than those of the control group [10.0%(5/50), 14.0%(7/50), respectively], P<0.05. Conclusion For GDM pregnant women with high risk factors, early treatment before 28 weeks of pregnancy can significantly reduce maternal and neonatal complications and improve pregnancy outcome.