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目的探讨对妊娠期糖尿病(GDM)孕妇给予合理饮食的管理方案,以降低围生期并发症。方法选择中国福利会国际和平妇幼保健院1998-01-2002-12170例GDM孕妇,随机分为制定食谱组(观察组)和口头指导组(对照组),两组孕妇均由产科医生定期随访,观察组同时有营养科医生定期随访。结果观察组81例(95·3%)孕妇孕期血糖控制满意,4例(4·7%)孕妇需加用胰岛素;对照组则有12例(14·1%)孕期需加用胰岛素,两组比较差异有显著性意义(P<0·05)。GDM的并发症依次为:妊娠期高血压疾病共24例(为14·1%),两组比较差异无显著意义(P>0·05);巨大儿21例(12·4%),其中观察组4例,对照组17例,两组比较差异有非常显著性意义(P<0·01);小于胎龄儿两组各2例,其中各有1例为双胎;两组孕妇均无羊水过多发生。观察组新生儿平均体重(3309·0±396·4)g,对照组(3565·1±640·4)g,其中新生儿体重>4200g者,观察组为0,对照组11例,两组比较差异有显著性意义(P<0·05)。结论对GDM孕妇进行合理的饮食管理,因人而宜制定食谱能够减少巨大儿的发生率,从而降低剖宫产率。
Objective To explore a reasonable diet for pregnant women with gestational diabetes mellitus (GDM) to reduce the complications of perinatal period. Methods Welfare International Peace Maternal and Child Health Hospital 1998-01-2002-12170 cases of GDM pregnant women were randomly divided into the formulation of the diet group (observation group) and the oral guidance group (control group), both groups of pregnant women were regular follow-up by the obstetrician, In the observation group, nutritionists were also followed up regularly. Results In the observation group, 81 pregnant women (95.3%) had satisfactory glycemic control during pregnancy, 4 (4.7%) pregnant women needed insulin and 12 (14.1%) pregnant women needed insulin during pregnancy. The difference was significant (P <0.05). The complications of GDM were as follows: gestational hypertension in 24 cases (14.1%), no significant difference between the two groups (P> 0.05); macrosomia in 21 cases (12.4%), of which There were 4 cases in the observation group and 17 cases in the control group. There were significant differences between the two groups (P <0.01) No polyhydramnios occurs. In the observation group, the average weight of newborn infants was (3309 · 0 ± 396 · 4) g and that of the control group (3565 · 1 ± 640 · 4) g, with the weight of neonates> 4200g, the observation group of 0, the control group of 11 patients, The difference was significant (P <0.05). Conclusions Reasonable diet management for pregnant women with GDM should be based on the fact that people should formulate recipes to reduce the incidence of macrosomia and thus reduce the rate of cesarean section.