不同喂养方式对糖尿病母亲新生儿血糖和体质量及胆红素的影响

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目的探讨不同喂养方式对糖尿病母亲新生儿血糖、胆红素及体质量下降的影响。方法糖尿病母亲新生儿217例,随机分为观察组110例和对照组107例。对照组出生后2~3h开始母乳喂养,母乳喂养困难者辅以人工喂养;观察组于出生30min内鼻饲或口饲质量分数10%葡萄糖5mL/kg,间隔1~2h喂食1次。分别于出生后1、2、3、6、12、24、48h检测2组血糖,记录新生儿低血糖症发生率;分别于出生后30min内及24、48、72、96h后测量2组体质量,计算体质量下降值;分别于出生后1、2、3、4d经皮测定胆红素水平,并进行比较。结果观察组生后2、3h血糖水平[(3.14±0.72)、(3.18±0.69)mmol/L]高于对照组[(3.01±0.45)、(3.02±0.51)mmol/L](P<0.05),出生后1、6、12、24、48h血糖水平比较差异均无统计学意义(P>0.05);2组出生后12、24、48h均未发生低血糖症,观察组生后2、3h低血糖症发生率(5.5%、2.7%)低于对照组(26.1%、17.8%)(P<0.05),生后1、6h低血糖症发生率比较差异无统计学意义(P>0.05);2组出生后24h体质量下降值比较差异无统计学意义(P>0.05),观察组出生后48、72、96h体质量下降值[(202.97±129.52)、(190.21±109.35)、(178.32±102.98)g]低于对照组[(219.98±145.36)、(229.54±124.35)、(238.58±136.21)g](P<0.05);2组出生后1d胆红素水平比较差异无统计学意义(P>0.05),观察组生后2、3、4d胆红素水平[(185.30±37.78)、(215.11±6.67)、(231.39±41.55)μmol/L]低于对照组[(192.89±50.96)、(234.44±55.58)、(251.03±58.14)μmol/L](P<0.05)。结论糖尿病母亲新生儿出生后积极干预可降低生后2、3h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 effects of different feeding methods on the blood glucose, bilirubin and body weight of newborns with diabetic mothers. Methods A total of 217 newborns with diabetic mothers were randomly divided into observation group (n = 110) and control group (n = 107). Control group 2 ~ 3h after birth, breastfeeding, breastfeeding were supplemented by artificial feeding; observation group within 30min nasal feeding or oral mass fraction of 10% glucose 5mL / kg, 1 ~ 2h feeding 1 time. Blood glucose was measured at 1, 2, 3, 6, 12, 24 and 48 h after birth to record the incidence of neonatal hypoglycemia. After 30 min and 24, 48, 72 and 96 h after birth, The body weight was calculated and the bilirubin level was measured by transdermal method at 1, 2, 3 and 4 days after birth respectively. Results The blood glucose level at 3 and 3 hours after birth in the observation group was significantly higher than that in the control group [(3.14 ± 0.72) and (3.18 ± 0.69) mmol / L, respectively] (3.01 ± 0.45 and 3.02 ± 0.51 mmol / L, respectively ), There were no significant differences in the blood sugar levels at 1, 6, 12, 24, and 48h after birth (P> 0.05). No hypoglycemia occurred at 12, 24 and 48h after birth in the 2 groups, 3h hypoglycemia (5.5%, 2.7%) was lower than that of the control group (26.1%, 17.8%) (P <0.05), and there was no significant difference in the incidence of hypoglycemia after birth ). There was no significant difference in body weight loss between the two groups at 24h after birth (P> 0.05), the body weight loss at 48, 72 and 96h after birth in the observation group [(202.97 ± 129.52), (190.21 ± 109.35, 178.32 ± 102.98) g] was lower than that of the control group [(219.98 ± 145.36), (229.54 ± 124.35), (238.58 ± 136.21) g] (P <0.05). There was no significant difference in bilirubin level between the two groups (P <0.05). The level of bilirubin in the observation group at 2, 3, 4 d after birth [(185.30 ± 37.78), (215.11 ± 6.67), (231.39 ± 41.55) μmol / L] 50.96), (234.44 ± 55.58), (251.03 ± 58.14) μmol / L] (P <0.05). Conclusion Positive intervention after newborn infants with diabetic mothers can reduce the incidence of hypoglycemia 2,3h after birth, reduce the growth rate of bilirubin and slow down the decline of body weight.
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