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目的探讨胰岛素对不同孕期妊娠期糖尿病(GDM)患者血糖水平及妊娠结局的影响。方法选取2015年1-12月的GDM患者115例,根据孕期将患者分为孕周<32周组(32例)、孕周32~34周组(40例)和孕周≥35周组(43例)。3组患者均采用胰岛素治疗,观察各组患者血糖变化、妊娠结局及新生儿并发症发生率。结果治疗前,3组空腹血糖及餐后2 h血糖水平比较差异均无统计学意义(P>0.05);分娩前,3组空腹血糖及餐后2 h血糖水平较治疗前均明显降低(P<0.05);孕周<32周组分娩前空腹血糖和餐后2 h血糖水平明显低于其他组(P<0.05);孕周32~34周组和孕周≥35周组分娩前空腹血糖和餐后2 h血糖水平比较差异均无统计学意义(P>0.05)。3组产后出血发生率比较差异无统计学意义(P>0.05);孕周<32周组妊娠期高血压疾病发生率、剖宫产率和早产发生率明显低于其他两组,差异均有统计学意义(均P<0.05)。3组新生儿窒息、新生儿低血糖及巨大儿发生率比较差异均无统计学意义(P>0.05)。结论胰岛素治疗能有效控制GDM患者血糖水平,早期干预效果较好,且对改善妊娠结局有一定作用。
Objective To investigate the effect of insulin on blood glucose level and pregnancy outcome in gestational diabetes mellitus (GDM) in different gestations. Methods A total of 115 GDM patients from January to December in 2015 were enrolled. According to their gestational age, the patients were divided into 32 weeks gestational age group (32 cases), 32 to 34 weeks gestational age group (40 cases) and 35 weeks gestational age group 43 cases). 3 groups of patients were treated with insulin, observed in each group of patients with blood glucose changes, pregnancy outcomes and neonatal complications. Results Before fasting, there was no significant difference in fasting blood glucose and postprandial blood glucose at 2 h before treatment (P> 0.05). Before delivery, the fasting blood glucose and 2 h postprandial blood glucose in 3 groups were significantly lower than before treatment (P <0.05). Fasting plasma glucose (FBG) before delivery and 2-hour postprandial plasma glucose were lower in gestational weeks <32 weeks than those in other groups (P <0.05) And 2 h postprandial blood glucose levels were no significant difference (P> 0.05). There was no significant difference in the incidence of postpartum hemorrhage between the three groups (P> 0.05). The incidence of gestational hypertension, cesarean section rate and preterm birth in gestational week <32 weeks group was significantly lower than the other two groups Statistical significance (all P <0.05). There was no significant difference in the incidence of neonatal asphyxia, neonatal hypoglycemia and macrosomia between the three groups (P> 0.05). Conclusion Insulin treatment can effectively control blood glucose levels in patients with GDM, early intervention is better, and to improve the outcome of pregnancy have a role.