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目的分析早期个体化营养干预对妊娠期糖尿病(GDM)孕妇血糖及并发症控制的作用。方法选取门诊治疗的GDM患者586例,其中425例接受个体化营养干预孕妇为观察组,161例接受普通营养干预孕妇为对照组,干预4周后比较两组患者饮食干预前、后餐后2 h血糖情况,并记录产妇并发症及剖宫产发生率情况。结果营养干预前,观察组患者与对照组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖及晚餐后2 h血糖差异均无统计学意义(P>0.05)。干预后,观察组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖及晚餐后2 h血糖水平均降低;对照组患者空腹血糖、早餐后2 h血糖、午餐后2 h血糖降低,晚餐后2 h血糖水平无改善;观察组患者干预后的血糖水平均低于对照组,差异有统计学意义(P<0.05)。饮食干预后,观察组患者妊娠期高血压、产后出血、胎膜早破及感染的发病率均低于对照组患者,差异有统计学意义(P<0.05)。观察组剖宫产率15.53%显著低于对照组剖宫产率30.43%,差异有统计学意义(P<0.01)。结论个体化营养干预能够有效控制妊娠期糖尿病孕妇的血糖稳定,达到降低孕产妇围产期并发症的作用,值得临床推广应用。
Objective To analyze the effect of early individualized nutrition intervention on the control of blood glucose and complications in pregnant women with gestational diabetes mellitus (GDM). Methods Outpatient treatment of 586 cases of GDM patients, of which 425 cases of individualized nutrition intervention pregnant women as the observation group, 161 cases of general nutrition intervention pregnant women as the control group, after 4 weeks of intervention, the two groups of patients before and after the intervention diet, postprandial 2 h blood glucose, and record maternal complications and cesarean section incidence. Results There was no significant difference in fasting blood glucose, blood glucose at 2 h after breakfast, blood glucose at 2 h after lunch, and blood sugar at 2 h after dinner between the observation group and the control group before nutrition intervention (P> 0.05). After intervention, fasting blood glucose (FBG), fasting blood glucose (2h after breakfast), blood glucose (2h after lunch) and blood sugar (2h after dinner) were decreased in the observation group. Fasting blood glucose, blood sugar at 2h after breakfast, blood sugar at 2h after lunch, The blood glucose level did not improve after 2 h; the blood glucose level in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). After dietary intervention, the incidence of gestational hypertension, postpartum hemorrhage, premature rupture of membranes and infection in observation group were lower than those in control group, with significant difference (P <0.05). The rate of cesarean section in the observation group was 15.53%, which was significantly lower than that in the control group (30.43%), the difference was statistically significant (P <0.01). Conclusion Individualized nutrition intervention can effectively control the blood glucose of pregnant women with gestational diabetes and reduce the complications of perinatal complications of pregnant women, which is worthy of clinical application.