口服葡萄糖水对糖尿病母亲新生儿血糖、胆红素及体质量的影响

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目的:探讨母亲妊娠期糖尿病新生儿(IDMs)口服葡萄糖对血糖、胆红素及体质量的影响。方法:选取2012年10月至2015年10月在我院出生的IDMs 217例,采用数字表法分为观察组110例与对照组107例。观察组新生儿于出生30 min内即用奶瓶或鼻饲(口饲)喂10%葡萄糖5 m L/kg,间隔1~2 h 1次,生后2~3 h开奶,直至连续血糖测定2次正常。对照组以母乳喂养为主,喂养困难者辅以人工喂养。两组新生儿均于生后1 h、2 h、3 h、6 h、12 h、24 h、48 h监测血糖,统计新生儿低血糖症、胆红素值、体质量等情况。结果:两组IDMs出生后不同时间点血糖水平比较,对照组生后2 h血糖为最低值,生后3 h为次最低值,与观察组2 h、3 h血糖值比较差异有统计学意义(P<0.05);两组生后1 h、6 h、12 h、24 h、48 h血糖值比较差异无统计学意义(P>0.05)。两组IDMs出生后1 h低血糖症发生率比较差异无统计学意义(P>0.05)。生后2 h、3 h观察组低血糖症发生率为5.5%、2.7%,对照组低血糖症发生率为26.1%、17.8%,两组比较差异有统计学意义(P<0.05)。对照组低血糖症发生率2 h最高,3 h次之,生后12 h、24 h、48 h血糖值在正常范围。对照组新生儿出生后体质量下降明显高于观察组,差异有统计学意义(P<0.05)。两组IDMs经皮胆红素测定比较,1 d日龄时胆红素水平差异无统计学意义,日龄2、3、4 d时对照组明显高于观察组,差异有统计学意义(P<0.05)。结论:IDMs生后口服葡萄糖水,可降低生后2 h、3 h低血糖症发生率,降低胆红素增长速度,减缓体质量下降。 Objective: To investigate the effect of oral glucose on blood sugar, bilirubin and body weight of mothers with gestational diabetes mellitus (IDMs). Methods: A total of 217 IDMs born in our hospital from October 2012 to October 2015 were selected and divided into observation group (110 cases) and control group (107 cases) by digital table. The newborns in the observation group were given 10% glucose 5 m L / kg by feeding bottle or nasal feeding (oral feeding) within 30 min of birth, once every 1 ~ 2 h and 2 ~ 3 h after birth until the continuous blood glucose measurement 2 Times normal. Control group mainly breastfeeding, feeding difficulties supplemented by artificial feeding. Blood glucose was monitored at 1, 2, 3, 6, 12, 24 and 48 h after birth in both groups of newborns, and the neonatal hypoglycemia, bilirubin value and body weight were measured. Results: The blood sugar levels of IDMs were different at different time points after birth. The blood glucose of the control group was the lowest at 2 hours after birth and the next lowest at 3 hours after birth, which was significantly different from the observation group at 2 and 3 hours (P <0.05). There was no significant difference in blood glucose between the two groups at 1 h, 6 h, 12 h, 24 h, 48 h after birth (P> 0.05). There was no significant difference in the incidence of hypoglycaemia between two groups of IDMs at 1 hour after birth (P> 0.05). The incidence of hypoglycemia in observation group was 5.5% and 2.7% at 2 h and 3 h after birth. The incidence of hypoglycemia in control group was 26.1% and 17.8%, respectively. There was significant difference between the two groups (P <0.05). The incidence of hypoglycemia in the control group was the highest at 2 h, followed by 3 h, and at 12 h, 24 h and 48 h after birth in the normal range. The birth weight of newborns in control group was significantly lower than that in observation group after birth, the difference was statistically significant (P <0.05). Two groups of IDMs percutaneous bilirubin determination, 1 d day bilirubin levels were no significant difference, 2, 3, 4 d day control group was significantly higher than the observation group, the difference was statistically significant (P <0.05). Conclusion: After oral administration of glucose water, IDMs can reduce the incidence of hypoglycemia 2 h and 3 h after birth, reduce the growth rate of bilirubin and slow down the decline of body weight.
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