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目的探讨多次口服葡萄糖耐量试验(OGTT)检查对高危孕妇产前诊断妊娠期糖尿病的临床应用价值。方法选择2012年2月-2015年1月在该院行产前检查的高危孕妇840例,其中按照医嘱及时复查高危孕妇652例(观察组),分别于孕24~28周和孕32~35周行75 g OGTT检查、Hb A1c检查。未按照医嘱及时复查高危孕妇188例(对照组),仅孕24~28周行75 g OGTT检查。观察妊娠期糖尿病检出以及胎盘异常或早产、新生儿Apgar评分等。结果观察组高危孕妇两次OGTT检查检出妊娠期糖尿病130例,检出率为19.94%,明显高于首次OGTT检查的5.21%,差异比较有统计学意义(P<0.05);观察组Hb A1c检出妊娠期糖尿病139例,检出率21.32%,与2次OGTT检查检出率比较无统计学意义(P>0.05);观察组发生胎盘异常或早产比例为7.21%,明显低于对照组的18.09%,差异有统计学意义(P<0.05);观察组新生儿Apgar评分为(8.90±0.07)分,明显高于对照组(8.17±0.10)分,差异有统计学意义(P<0.05);观察组住院时间为(6.05±0.14)d,明显短于对照组(8.94±0.20)d,差异有统计学意义(P<0.05)。结论高危孕妇2次OGTT检查可提高妊娠期糖尿病检出率,为早期诊断和治疗提供依据,改善母婴结局,值得临床推广使用。
Objective To investigate the clinical value of multiple oral glucose tolerance test (OGTT) in prenatal diagnosis of gestational diabetes mellitus in high-risk pregnant women. Methods A total of 840 high-risk pregnant women underwent prenatal examinations from February 2012 to January 2015 were enrolled. Among them, 652 high-risk pregnant women (observation group) Weekly 75 g OGTT examination, Hb A1c examination. 188 cases of high-risk pregnant women who did not follow the doctor’s order promptly were examined (control group), 75 g OGTT was performed only 24-28 weeks pregnant. Observe gestational diabetes and placental abnormalities or premature birth, neonatal Apgar score. Results In observation group, 130 pregnant women with gestational diabetes mellitus were detected by OGTT twice in pregnancy. The detection rate was 19.94%, which was significantly higher than that of the first OGTT (5.21%) (P <0.05). Hb A1c 139 cases of gestational diabetes mellitus were detected, the detection rate was 21.32%, which was not significantly different from that of 2 times OGTT (P> 0.05). The proportion of placental abnormalities or preterm birth in observation group was 7.21%, which was significantly lower than that of control group (P <0.05). The Apgar score of neonates in the observation group was (8.90 ± 0.07) points, which was significantly higher than that of the control group (8.17 ± 0.10), the difference was statistically significant (P0.05 ). The length of stay in the observation group was (6.05 ± 0.14) d, which was significantly shorter than that in the control group (8.94 ± 0.20) d, the difference was statistically significant (P <0.05). Conclusion High-risk pregnant women 2 times OGTT examination can improve the detection rate of gestational diabetes, providing the basis for early diagnosis and treatment to improve the outcome of maternal and infant, it is worth clinical promotion and use.