妊娠期糖尿病护理干预对孕妇及围产儿结局的影响

目的 分析妊娠期糖尿病护理干预对孕妇及围产儿结局的影响。方法 选择2016年2月至2019年2月在我院就诊的60例妊娠期糖尿病患者。通过数字抽签分组方法分为干预组和对照组,两组各30例,对照组实施常规护理,干预组实施针对性护理干预。观察护理前后两组产妇的血糖水平,自我效能（GSES）和焦虑（HAMA）评分,两组产妇的分娩方式和妊娠结局,以及围产儿结局。结果 护理后,两组患者空腹和餐后2 h血糖水平均下降,且干预组空腹和餐后2 h血糖水平均低于对照组（P <0.05）;两组患者的GSES和HAMA评分均改善,且干预组护理后的GSES评分高于对照组,HAMA评分低于对照组（P <0.05）。干预组自然分娩率高于对照组（P <0.05）;干预组不良妊娠结局发生率低于对照组（P <0.05）;干预组围产儿不良结局发生率低于对照组（P<0.05）。结论 妊娠期糖尿病护理干预能够提高孕妇的血糖控制效率,改善患者的心理状态,让孕妇或围产儿获得更良好的结局。     

妊娠期肝内胆汁淤积症与围产儿结局

妊娠期肝内胆汁淤积症（ＩＣＰ）是特发于妊娠期间，可导致围产儿不良结局的一种妊娠并发症，常被误诊为肝炎、胆石症或被漏诊。本文对我院三年来的ＩＣＰ病例进行分析，探讨其对围产儿的影响。资料与方法病例选择为１９９４年１月～１９９７年６月在本院住院分娩孕产妇共...     

妊娠期糖尿病与妊娠结局的关系

目的探讨妊娠期糖尿病对妊娠结局的影响。方法对84例经糖尿病筛查并确诊的GDM患者临床资料作回顾性分析,按治疗方式分为未治疗组42例（A组）,饮食控制加胰岛素治疗组45例（B组）,对比2组的妊娠结局。结果B组妊娠期高血压、胎盘早剥、羊水过多、产时出血、产后感染（19．6％、0％、0％、2．0％、3．9％）均低于A组（42．9％、7．1％、4．8％、7．1％、9．5％）（t=2．123,t=2．241,t=2．135,t=2．312,t=2．309,P〈0．05）;B组孕周（33．3％）明显低于A组（23．8％）（X2=3．95,P〈0．05）;A组剖宫产率（69．0％）明显高于B组（22．2％）（X2=4．01,P〈0．05）;B组死胎死产（0％）明显低于A组（9．5％）X2=7．89,P〈0．01）;B组新生儿体重高于A组（t=2．209,P〈0．05）,新生儿合并症均低于A组（X2=6．89,X2=7．09,X2=7．49,X2=6．99,X2=7．29,X2=7．39,P均〈0．01）。结论妊娠期糖尿病对母婴危害大。及早诊断和治疗妊娠期糖尿病,可减少母婴并发症,降低围产儿死亡率。     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

妊娠期糖尿病与妊娠结局的关系

Objective To evaluate the influence of gestational diabetes mellitus(GDM) on the pregnancy outcome. Methods 84 cases with GDM by the clinical data of patients with GDM were analyzed retrospectively;84 cases were divided into untreated group(A group)42 cases and diet plus insulin treatment group(B group)45 cases, compared 2 groups of pregnancy outcome. Results In B group of pregnancy - induced hypertension, placental abrup-tion, polyhydranmios,when the middle class bleeding, puerperal infection (19.6%, 0%, 0%, 2.0%, 3.9%) were lower than A group (42.9%, 7.1% ,4.8% ,7.1%, 9.5%) (t=2.123,t =2.241,t =2.135,t =2. 312,t =2.309,P <0.05) ;In B group of gestational age(33.3%) was significantly lower than A group(23.8%) (χ2 = 3.95, P <0.05) ; In A group of cesarean section rate (69.0%) was significantly higher than the B group (22.2%) (χ2=4.01, P <0.05) ;in B group of stillbirth group (0%) was significantly lower than A group (9.5 %) (χ2= 7.89, P <0.01) ;In B group of birth weight was higher than A group(t = 2.209, P < 0.05), neonatal complications was lower than A group(χ2 =6.89,χ2 =7.09,χ2 =7.49,χ2=6.99,χ2 =7.29,χ2=7.39,P <0.01). Conclusion Pregnan-cy with diabetes is harmful to mother and infant. Diagnosing and treating the eases earlier can decrease the complica-tions of mother and infant as well as the death rate of perinatal fetus.     

加强孕期管理对妊娠期糖尿病妊娠结局的影响

目的 探讨加强孕期管理对妊娠期糖尿病(gestational diabetes mellitus,GDM)妊娠结局的影响.方法 对115例GDM孕妇加强孕期管理,有效控制血糖,并与正常妊娠组进行对照,观察两组妊娠结局.结果 GDM孕妇经过饮食、运动疗法,孕期加强母婴监护,剖宫产率高于对照组,差异有统计学意义(P＜0.05),但羊水过多、妊娠高血压、早产、产后出血、胎儿窘迫、巨大儿,新生儿低血糖、窒息及病理性黄疸等妊娠并发症与对照组比较差异无统计学意义(P＞0.05).结论 对GDM孕妇加强孕期管理可有效控制血糖,明显改善妊娠结局.     

妊娠合并糖尿病患者终止妊娠时间选择对母婴预后的影响

目的 探讨选择不同时间终止妊娠对妊娠合并糖尿病产妇及胎婴预后的影响.方法 回顾性分析64例妊娠合并糖尿病患者的资料,按终止妊娠的孕周将患者分三组,A组25例为38周前终止妊娠;B组32例为38～＜40周终止妊娠;C组7例为40～42周终止妊娠.结果 （1）三组患者均有并发症发生,其中C组患者发生酮症酸中毒1例（14.3%）,胎儿窘迫4例（57.1%）,与A、B组比较,差异有统计学意义（P＜0.05）.（2）三组围生儿结局比较,A组死亡1例,死亡率为4.0%;C组胎儿生长受限、巨大儿、新生儿呼吸窘迫综合征发生率均最高,分别为14.3%（1/7）,71.4%（5/7）,14.3%（1/7）,与A、B组比较差异有统计学意义.（3）三组患者分娩方式比较,差异有统计学意义（P＜0.05）,三组患者剖宫产率均高于阴道分娩率,B组患者剖宫产率达87.5%.结论 妊娠合并糖尿病患者应根据病情轻重,发病孕周及胎儿宫内状况采取个体化的治疗方案,选择恰当的时机终止妊娠,能取得较好的母婴结局,保守治疗时应实施严密监护.     

妊娠期糖尿病患者血糖控制对妊娠结局的影响

目的 探讨妊娠期糖尿病孕妇血糖的控制对母体、围生儿并发症和妊娠结局的影响.方法 将定期产前检查的孕妇中妊娠期糖尿病孕妇92例,根据治疗后血糖控制情况分为A组(血糖控制满意组)59例和B组(血糖控制不满意组)33例,另以健康孕妇95例为对照组.对母体、围生儿并发症和妊娠结局进行对比分析.结果 妊娠期糖尿病A组中妊娠期高血...     

妊娠期糖尿病患者肿瘤坏死因子与胰岛素抵抗的相关性研究

目的 研究妊娠期糖尿病患者肿瘤坏死因子(TNF)与胰岛素水平的关系.方法 采用氧化酶法测定普通2型糖尿病、妊娠期糖尿病患者及健康对照者的空腹血糖(FPG),放射免疫法检测血胰岛素(FINS)、TNF.采用稳态模型胰岛素抵抗指数(HOMA-IR)评价胰岛素敏感性.结果 妊娠期糖尿病患者TNF-α、FPG、FINS及HOMA-IR均高于2型糖尿病患者(P＜0.05),而糖尿病患者则高于健康对照者(P＜0.05).2型糖尿病及妊娠期糖尿病患者血清TNF-α与FINS、HOMA-IR呈正相关(r=0.66、0.39,P＜0.05).结论 TNF与胰岛素抵抗可能共同参与了妊娠期糖尿病的形成和发展.     

胰岛素对不同孕周妊娠期糖尿病患者血糖控制及妊娠结局影响的 Meta分析

目的系统评价胰岛素对不同孕周妊娠期糖尿病患者血糖控制及妊娠结局,为临床治疗提供循证医学依据。方法检索PubMed、Embase、Cochrane Library、中国学术期刊全文数据库（CNKI）、维普中文期刊全文数据库（VIP）、中国生物医学文献数据库（CBM）和万方数据库,收集观察组（孕周≤ 32周）对比对照组（孕周>32周）的妊娠期糖尿病患者使用胰岛素的病例对照研究,检索时间均为建库至2020年10月,筛选文献、提取数据和质量评价后,用RevMan5.3软件进行Meta分析。结果共纳入15项研究,1 637例妊娠期糖尿病患者。Meta分析结果显示,观察组分娩时空腹血糖（SMD=-0.37,95% CI=-0.47~-0.27）、产后2 h血糖（SMD=-0.42,95% CI=-0.52~-0.32）均显著小于对照组（P<0.01）;暴露组早产（OR=0.35,95% CI=0.25~0.48）、剖宫产（OR=0.57,95% CI=0.46~0.71）、妊娠期高血压（OR=0.40,95% CI=0.30~0.54）、羊水过多（OR=0.35,95% CI=0.23~0.52）、产后出血（OR=0.41,95% CI=0.26~0.64）和产后感染（OR=0.22,95% CI=0.12~0.38）均显著小于对照组（P<0.01）;观察组巨大儿（OR=0.41,95% CI=0.31~0.55）、新生儿窒息（OR=0.23,95% CI=0.15~0.35）、新生儿低血糖（OR=0.24,95% CI=0.15~0.37）、高胆红素血症（OR=0.29,95% CI=0.18~0.47）和新生儿低体质量（OR=0.31,95% CI=0.20~0.49）均显著小于对照组（P<0.01）。结论对于GDM患者孕早期（孕周≤ 32周）开始使用胰岛素更能有效控制产妇血糖水平,降低母儿围产期不良结果发生率。     

护理干预对妊娠期糖尿病患者母婴结局的影响

目的：探讨护理干预对妊娠期糖尿病（ GDM）患者母婴结局的影响。方法选取2013年徐州瑞博医院妇产科收治的GDM患者150例,根据护理方法不同将患者分为护理干预组和常规护理组,各75例。常规护理组患者予以常规护理,护理干预组患者予以心理护理、药物护理、运动护理和饮食护理。观察两组患者干预前后空腹血糖、糖化血红蛋白、C反应蛋白（ CRP）变化情况及母婴结局〔妊娠结局（ HDCP、胎膜早破、羊水过多、早产）、新生儿结局（剖宫产、巨大儿、胎儿宫内窘迫、新生儿窒息）〕。结果干预前两组患者空腹血糖、糖化血红蛋白、CRP水平比较,差异无统计学意义（ P>0.05）,干预后护理干预组患者空腹血糖、糖化血红蛋白、CRP水平低于常规护理组,差异有统计学意义（ P<0.05）;护理干预组HDCP、胎膜早破、羊水过多、剖宫产、早产、新生儿窒息、胎儿宫内窘迫、巨大儿发生率低于常规护理组,差异均有统计学意义（ P<0.05）。结论护理干预对GDM患者母婴结局有积极影响,可改善患者血糖水平,降低母婴不良事件发生率。     

饮食干预对妊娠期糖尿病患者血糖控制及母婴结局的影响

目的 探讨饮食干预对妊娠期糖尿病（GDM）患者血糖控制及母婴结局的影响.方法 将80例GDM患者按数字表法随机分为观察组和对照组,各40例.对照组采用传统的围生保健,观察组在此基础上给予个体化的饮食干预策略.比较分析两组患者血糖控制情况及母婴结局.结果 观察组和对照组的糖化血红蛋白、产后空腹血糖和餐后2h血糖及胱抑素C值分别为（5.07±0.73）％和（5.07±0.73）％,（4.47±0.29） mmol/L和（5.31±0.64） mmol/L,（6.84±1.31） mmol/L和（8.45± 1.37） mmol/L,（1.11 ±0.32） mg/L和（1.76±0.44） mg/L,差异均有统计学意义（=5.38、6.91、7.81、3.45,均P＜0.05）;观察组妊娠期高血压疾病、剖宫产、产后出血发生率分别为5.0％、20.0％、7.5％,均显著低于对照组的22.5％、57.5％、30.0％（x2=5.16、11.85、6.65,均P＜0.05）;与对照组比较,观察组的围生儿在早产、巨大儿、新生儿低血糖的并发症方面均显著降低（x2 =3.91、4.50、4.02,均P＜0.05）.结论 GDM与妊娠结局密切相关,加强饮食干预可有效降低母婴并发症,改善围生儿预后.     

妊娠期糖尿病患者孕期体质量增长与胎儿出生体质量的关系及对妊娠结局的影响

目的 探讨妊娠期糖尿病(GDM)患者孕期体质量增长与胎儿出生体质量的关系及对妊娠结局的影响.方法 收集132例GDM患者孕期血糖、体质量、产前糖化血红蛋白(HbA1c)、分娩情况、新生儿体质量及并发症情况,按照孕前体质量指数(BMI)进行分组,研究在不同体质量基础上孕期体质量增长对胎儿及妊娠结局的影响.结果 孕期体质量增加越多,胎儿出生体质量越高;体质量过轻组孕期体质量增加超过15 kg时,胎儿出生体质量明显增加,差异有统计学意义(P＜0.05).各组中随着体质量的增加,需要行剖宫产术和出现不良妊娠结局的比例也升高.结论 GDM患者孕期体质量增长与胎儿出生体质量相关,针对不同孕前体质量的GDM患者采取积极的饮食治疗措施,使孕期体质量恰当地增长,能控制胎儿出生体质量于合理范围,减少不良妊娠结局的出现.     

妊娠期糖尿病产妇围生结局与血糖控制情况的关系研究

目的 分析血糖控制与妊娠期糖尿病（GDM）产妇围生期结局之间的关系.方法 选取本院2012年1月～2013年6月收治的60例妊娠期糖尿病孕妇为研究对象,依照入院顺序随机分为观察组和对照组,对照组早晚餐前混合胰岛素皮下注射,观察组三餐前及睡前分别皮下注射短效和长效胰岛素,参照30例健康孕妇的相关资料,对比两组血糖控制效果及围生结局.结果 观察组血糖控制效果更佳、新生儿体重优于对照组（P＜0.05）,巨大儿比率与对照组差异无统计学意义（P＞0.05）;观察组均顺利分娩,围生结局优于对照组（P＜0.05）.结论 三餐前及睡前分别皮下注射短效和长效胰岛素血糖控制效果更佳,同时产妇围生结局更理想,此种治疗方案可作为妊娠期糖尿病的首选血糖控制途径.