摘要
目的探究早期给予妊娠期糖尿病患者胰岛素治疗对血糖控制及妊娠结局的影响。方法选取2018年1月—2021年1月福建省建瓯市妇幼保健院妇产科收治的80例妊娠期糖尿病患者为研究对象,按照应用胰岛素治疗时孕周将患者划分为观察组(40例)及对照组(40例)。观察组在孕32周前开始予以胰岛素治疗,对照组在孕周≥32周时给予胰岛素治疗,均持续用药治疗至妊娠结束。对比两组治疗前后血糖水平变化,并记录两组患者不良分娩结局、不良新生儿结局发生率。结果治疗后,两组空腹血糖、餐后2h血糖水平较治疗前均下降,且观察组低于对照组,差异有统计学意义(P<0.05);观察组早产、剖宫产的发生率均低于对照组,差异有统计学意义(P<0.05);观察组感染及产后出血的发生率均低于对照组,但差异无统计学意义(P>0.05);观察组低出生体重儿、巨大儿及新生儿低血糖的发生率均低于对照组,差异有统计学意义(P<0.05);观察组新生儿窒息、高胆红素血症及围生期死亡的发生率均低于对照组,但差异无统计学意义(P>0.05)。结论早期(孕32周之前)开始给予妊娠期糖尿病患者胰岛素治疗能更好地控制空腹血糖及餐后2h血糖水平,减少不良分娩结局与不良新生儿结局发生,改善母婴结局,值得提倡。
Objective To investigate the effect of early administration of insulin therapy on glycemic control and pregnancy outcome in patients with gestational diabetes mellitus.Methods 80 patients with gestational diabetes mellitus admitted to the Department of Obstetrics and Gynecology of Jian’ou Maternal and Child Health Hospital from January 2018 to January 2021 were selected as the research object.The patients were divided into observation group(40cases)and control group(40 cases)according to the gestational week when insulin treatment was applied.The observation group began to receive insulin treatment before 32 weeks of pregnancy,while the control group was treated with insulin at≥32 weeks of gestation,and both continued to be treated until the end of pregnancy.The changes in blood glucose levels before and after treatment were compared between the two groups,and the incidence of adverse birth outcomes and adverse neonatal outcomes were recorded in both groups.Results After treatment,fasting blood glucose and 2 h postprandial blood glucose levels decreased in both groups compared with those before treatment,and the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of preterm labor and cesarean delivery in the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of infection and postpartum hemorrhage in the observation group were lower than those of the control group,but the difference was not statistically significant(P>0.05).The incidence of low birth weight infants,huge infants and neonatal hypoglycemia in the observation group were lower than those of the control group,but the difference was statistically significant(P<0.05).The incidence of neonatal asphyxia,hyperbilirubinemia and perinatal death in the observation group were lower than those of the control group,but the difference was not statistically significant(P>0.05).Conclusion Insulin treatment for patients with gestational diabetes started early(before 32 weeks of pregnancy)can better control fasting glucose and 2 h postprandial glucose levels,reduce the occurrence of adverse birth outcomes and adverse neonatal outcomes,and improve maternal and infant outcomes,which is worth advocating.
作者
林惠群
LIN Huiqun(Department of Obstetrics and Gynecology,Jian'ou Maternal and Child Health Hospital,Jian'ou,Fujian Province,353100 China)
出处
《糖尿病新世界》
2022年第23期125-128,共4页
Diabetes New World Magazine
关键词
妊娠期糖尿病
胰岛素
血糖控制
妊娠结局
Gestational diabetes mellitus
Insulin
Glycemic control
Pregnancy outcome
