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目的评价不同干预方案对妊娠期糖尿病(GDM)产妇糖化血红蛋白(Hb A1c)水平及妊娠结局的影响。方法选取2014年8月-2016年8月在陇南市第一人民医院妇产科分娩的GDM产妇92例,根据干预方法不同分为A、B两组,每组46例,其中A组予以常规干预,B组在A组基础上采用综合管理干预。比较两组产妇Hb A1c水平及妊娠结局。结果干预后,两组产妇Hb Alc水平均较干预前明显下降,差异有统计学意义(P<0.05),而B组下降幅度更大,与A组比较差异有统计学意义(P<0.05);B组剖宫产(45.65%vs.69.56%)、产后感染(6.52%vs.21.74%)、妊娠期高血压(8.69%vs.26.09%)、羊水过多(6.52%vs.21.74%)和产后出血(6.52%vs.23.91%)等孕产妇不良妊娠结局发生率显著低于A组,差异均有统计学意义(均P<0.05),巨大儿、早产儿、新生儿窒息及新生儿低血糖等围生儿并发症发生几率亦明显低于A组,差异有统计学意义(P<0.05)。结论综合管理干预可控制GDM产妇的血糖水平,改善妊娠结局。
Objective To evaluate the effects of different interventions on gestational diabetes mellitus (GDM) maternal HbA1c level and pregnancy outcome. Methods 92 cases of GDM maternal childbirth in the First People’s Hospital of Longnan from August 2014 to August 2016 were divided into two groups according to the method of intervention: group A and group B, with 46 cases in each group, in which group A received routine Intervention, Group B based on Group A using integrated management intervention. Hb A1c levels and pregnancy outcomes were compared between the two groups. Results After intervention, the levels of Hb Alc in both groups were significantly lower than those before intervention (P <0.05), while the decrease in group B was more significant (P <0.05) (45.65% vs.69.56%), postpartum infection (6.52% vs.21.74%), gestational hypertension (8.69% vs.26.09%) and polyhydramnios (6.52% vs.21.74% And postpartum hemorrhage (6.52% vs.23.91%). The incidence of adverse pregnancy outcomes in pregnant women was significantly lower than that in group A (all P <0.05). The incidence of maternal and neonatal asphyxia and newborns The incidence of perinatal complications such as hypoglycemia was also significantly lower than that in group A (P <0.05). Conclusion Comprehensive management intervention can control the blood sugar level of GDM maternal and improve the pregnancy outcome.