妊娠糖尿病对母婴影响的分析

目的探讨妊娠糖尿病（GDM）对母婴影响。方法观察妊娠糖尿病患者36例及健康孕妇36例,分析其妊娠结局。结果GDM组妊娠期高血压疾病、早产、巨大儿及剖宫产发生率分别为41.7%、27.7%、25%及58.3%,明显高于对照组16.7%、8.3%、5.5%及27.7%,差异有显著性（P〈0.05）。结论GDM是危害孕产妇和围产儿的妊娠并发症,早期诊断GDM及控制血糖是减少母婴并发症的关键。     

妊娠合并糖尿病的母婴监护体会

妊娠合并糖尿病(GDM)主要指在原有糖尿病基础上合并妊娠者，或妊娠前为隐性糖尿病，妊娠后发展为临床糖尿病患者。现将我院2003年1月至2004年12月对36例GDM患者进行母婴监护的体会介绍如下。     

妊娠合并糖尿病34例临床分析

目的 探讨妊娠合并糖尿病对孕产妇并发症、分娩方式与围产结局、围产儿并发症的影响.方法 回顾性分析2001年1月1日至2006年9月30日34例在本院分娩的妊娠合并糖尿病（A组）与随机选择同期未发生糖尿病高危因素的正常孕产妇34例（B组）,就孕产妇并发症、分娩方式、围产结局、围产儿情况作比较分析.结果 患糖尿病组孕产妇体重指数＞30者及早产、妊娠期高血压疾病明显高于对照组,其他与对照组比较差异均无统计学意义.巨大儿、早产儿明显高于对照组,剖宫产率与对照组比较差异显著.结论 妊娠合并糖尿病对孕产妇并发症、分娩方式与围产结局有明显影响,需加强孕期管理和产时临床处理,减少母婴并发症.     

妊娠合并糖尿病的优生探讨

妊娠合并糖尿病是妊娠期孕妇最常见的并发症之一,发病率为5%-20%[1].妊娠合并糖尿病按确诊时间可分为两类,一是在妊娠前已经确诊有糖尿病(包括糖尿病Ⅰ型和Ⅱ型),即孕前糖尿病(diabetes mellitus,DM),一是在妊娠期首次确诊为糖尿病,即妊娠期糖尿病(gestational diabetes mellitus,GDM).所谓妊娠期糖尿病是指在妊娠期间发生或首次识别的严重程度不同的糖类不耐受,且不排除糖类不耐受在妊娠前己经存在的可能性[2].     

38例妊娠合并糖尿病孕妇护理措施探讨

目的 探讨妊娠期糖尿病患者在妊娠、分娩、产后各阶段的护理措施.方法 在妊娠期做到早确诊、加强心理护理、严格控制饮食、合理治疗、控制血糖;在分娩期,建立静脉通道,严密观察产程的进展;新生儿出生后按早产儿护理,预防并发症;在产后,预防产后低血糖和产后出血.结果 阴道分娩28例,行子宫下段剖宫术7例,终止妊娠3例;巨大儿2例,新生儿低血糖1例,呼吸窘迫综合症2例,早产3例.结论 加强对糖尿病患者在妊娠、分娩、产后各阶段及新生儿的护理,可使患者的病理妊娠、分娩期并发症及胎儿的并发症显著下降,可降低孕产妇及围产儿死亡率,促进母婴健康.     

381例妊娠期糖尿病血糖管理与母婴妊娠结局的临床分析

目的探讨妊娠期糖尿病孕妇系统管理对母婴妊娠结局的影响。方法收集我院2008年1月～2009年12月诊断的妊娠期糖尿病病例381例,分为系统管理组241例和未管理组140例。比较两组病例妊娠并发症及围生儿结局。结果妊娠期糖尿病未管理组子痫前期、羊水过多、早产的发生率较系统管理组明显升高(P0.05);巨大儿、新生儿高胆红素血症、、新生儿低血糖、心肌病变(包括先天性心脏病)、新生儿呼吸窘迫综合征(NRDS)及胎粪吸入综合征(MAS)的发生率亦明显高于系统管理组(P0.01),而新生儿窒息率的差异无显著性意义(P0.05)。结论妊娠期糖尿病与妊娠并发症密切相关,未系统管理及血糖未控制者围生儿结局不良,应加强对妊娠期糖尿病孕妇的孕期管理。     

妊娠合并糖尿病孕产妇死亡病因分析

目的探讨加强妊娠合并糖尿病围产期保健。方法回顾分析2004年-2005年2年我省10例妊娠合并糖尿病孕产妇死亡病例,根据孕产妇死亡报告卡,了解如文化程度、孕产次、产前检查、分娩地点、抢救情况及死亡原因。结果死亡原因肾衰,多器官功能衰竭占70%,酮症酸中毒,高渗性昏迷及心衰、高血压脑病各占10%,孕产妇文化程度普遍较低,小学或文盲占60%,初中30%,高中仅占10%,70%未按受产前检查,接受3次或以上仅占10%,专家对死亡病例评审结果：医疗保健部门知识技能问题占30%,个人知识及家庭态度占50%。结论提高孕产妇文化素质,加强糖尿病基本知识教育,自觉进行产前检查,开展妊娠糖尿病筛查,正规使用胰岛素控制血糖,提高医疗保健部门知识技能,及时处理急性并发症,是围产期保健的关键。     

妊娠合并卵巢肿瘤临床病理分析

目的探讨妊娠合并卵巢肿瘤的临床病理特征及诊断处理方案。方法对手术、病理诊断明确的78例妊娠合并卵巢肿瘤孕妇的临床病理资料进行回顾性分析。结果经手术、病理诊断明确的妊娠合并卵巢肿瘤78例,占同期妊娠者的0.09%(78/84253),良性肿瘤占96.15%(75例),以良性畸胎瘤、上皮性囊肿多见。卵巢交界性肿瘤占2.56%(2例),卵巢恶性肿瘤占1.28%(1例),并发症以卵巢肿瘤蒂扭转多见。大多行一侧附件切除术或卵巢肿瘤剔出术。结论妊娠合并卵巢肿瘤多为良性,无明显症状,应注意早期诊断,处理应根据孕周和肿瘤的性质区别对待。     

糖尿病母亲婴儿围产期心肺并发症及其预后

目的　探讨糖尿病母亲婴儿的围产期心肺并发症及其预后。方法　对 4 1例糖尿病母亲婴儿的心肺并发症及预后情况进行总结分析。结果　围产期窒息 17例 (41.5 % ) ,吸入性肺炎 5例 (12 .2 % ) ,胎粪吸入综合征和肺透明膜病各 2例(4.9% ) ,湿肺 5例 (12 .2 % ) ;肥厚性心肌病 2例 (4.9% ) ,先天性心脏病 3例 (7.3% )。 37例痊愈 ,2例好转后退院 ,2例死亡。死亡的 2例患儿均伴窒息和吸入性肺炎 ;围产期窒息、吸入性肺炎的发生与孕母血糖的控制情况密切相关 ,差异显著 (P <0 .0 5 )。结论　正确处理糖尿病母亲婴儿的各种并发症 ,尤其是心肺并发症是提高生存率、降低死亡率的重要措施。     

正常妊娠、妊娠糖尿病和妊娠糖尿病合并高血压综合征及其有关因素的探讨

目的探讨正常妊娠.妊娠糖尿病.妊娠糖尿病合并妊娠高血压综合征孕妇有关脂类,肾功、糖、胱抑素C方面变化特点。方法将146例孕妇孕周都为35~40周分为3组。Ⅰ组,正常妊娠组45例;Ⅱ组,妊娠糖尿病组51例;Ⅲ组,妊娠糖尿病合并高血压综合征50例。结果(1)Ⅱ组、Ⅲ组较Ⅰ组血糖有显著差异(P0.01);(2)Ⅱ组、Ⅲ组脂类分析较Ⅰ组有显著差异(P0.01);(3)Ⅲ组较Ⅰ组、Ⅱ组肾功、胱抑素C比较有显著差异(P0.01)。结论妊娠期糖尿病的孕妇较正常的孕妇更容易诱发妊娠高血压综合征。     

Factors associated with diabetes mellitus prediction among pregnant Arab subjects with gestational diabetes

There is scarcity of available information on the possible significant risk factors related to diabetes mellitus (DM) prediction among expectant Saudi mothers with gestational diabetes mellitus (GDM). The present study is the first to identify such risk factors in the Arab cohort. A total of 300 pregnant subjects (mean age 33.45 ± 6.5 years) were randomly selected from all the deliveries registered at the Obstetrics Department of King Fahad Medical City, Riyadh Saudi Arabia from April 2011 to March 2013. Demographic and baseline glycemic information were collected. A total of 7 highly significant and independent risk factors were identified: age, obesity, and family history of DM, GDM < 20 weeks, macrosomia, insulin therapy and recurrent GDM. Among these factors, subjects who had insulin therapy use are 5 times more likely to develop DMT2 (p-value 3.94 × 10^-14) followed by recurrent GDM [odds-ratio 4.69 (Confidence Interval 2.34-4.84); P = 1.24 × 10^-13). The identification of the risk factors mentioned with their respective predictive powers in the detection of DMT2 needs to be taken seriously in the post-partum assessment of Saudi pregnant patients at highest risk.     

妊娠前体质指数和胎次对妊娠糖尿病发病的影响

目的：探讨妊娠前体质指数(body mass index,BMI)、胎次与妊娠糖尿病(gestational diabetes mellitus,GDM)发病的关系,并探讨其对妊娠糖尿病(GDM)发病的影响。方法：本研究选择我院2014年2月至2014年12月接受孕产期检查、临床资料完整的且患有妊娠糖尿病的孕妇262名,对其采取葡萄糖耐量实验(OGTT实验),按照WTO标准,对262例足月妊娠初产妇女在孕24~28周常规进行75 g口服糖耐量试验,并完整记录年龄、孕周、文化程度、妊娠前体质指数及胎次等临床资料。根据妊娠前体质指数(BMI)将孕妇分为BMI分为4组,BMI<18.5 kg/m2者为偏瘦组,BMI 18.5~23.0 kg/m2者为正常体质量组,BMI 23.1~25.0 kg/m2者为超重组,BMI>25.0 kg/m2为肥胖组,采用SPSS l8.0统计软件对资料进行描述性分析、两样本t检验、非条件Logistic回归分析两组孕妇妊娠前体质指数(BMI)、胎次与妊娠糖尿病的关系。结果：4组OGTT结果显示妊娠前超重或肥胖的孕妇发生妊娠糖尿病的风险高于正常和偏瘦体质量组;非条件logistic回归分析结果表明,影响GDM的因素依次为：胎次、体质指数、年龄、文化程度,各影响因素回归系数分别为：2.372、     

妊娠期糖尿病的治疗对母婴预后的影响

目的分析妊娠期糖尿病的治疗对母体及围产儿预后的影响。方法分析我院收治的234例妊娠期糖尿病患者的临床资料,根据血糖控制程度分为治疗满意组及治疗不满意组,对比两组母体并发症、围产儿并发症及与治疗的关系。结果治疗不满意组母体并发症、围产儿并发症的发病率高于满意组(P<0.05)。终止妊娠时间以37~40孕周为宜,与<37孕周及>40孕周相比,新生儿病率及病死率最低(P<0.05)。结论妊娠期糖尿病治疗中严格控制血糖,是减少母体、围产儿并发症,改善预后的关键。     

糖尿病对精液质量的影响及其机制

糖尿病是由多种病因引起的代谢性疾病,不仅影响男性性功能而且影响男性精液质量。本文综述了糖尿病对男性精液的影响如精子活动力、精子密度、精子DNA损伤等及其发生机制。     

长链非编码RNA与糖尿病关系的研究进展*

Long non-coding RNAs (lncRNAs) are a group of RNAs, which are longer than 200 nucleotides without containing functional open reading frame and cannot encode protein. The study of lncRNA will help to understand the multi-level expression regulatory network of the body, and is expected to provide the basis of prediction, diagnosis and treatment of complex diseases. Although the functions and mechanism of lncRNA remain unclear, some studies indicate that lncRNA is involved in the development of diabetes mellitus, and those lncRNAs may be new diagnostic markers and therapeutic targets.     

Factors affecting outcome after total knee arthroplasty in patients with diabetes mellitus

PURPOSE: To compare the clinical outcome and complications following total knee arthroplasty (TKA) in diabetic and non-diabetic patients, and to identify diabetes-related risk factors for negative outcomes. MATERIALS AND METHODS: 222 primary TKAs in patients with diabetes were evaluated using Knee Society scores and Hospital for Special Surgery score. Postoperative complications were reviewed retrospectively. The mean follow-up was 53.2 months. The effect of diabetes-related factors and comparison with a matched control group were analyzed statistically. RESULTS: Significant improvements were noted in all the scores after TKA (p < 0.05). There was no statistical difference in clinical sores between the diabetic and non-diabetic patients. In multivariate analysis associating age, gender and body mass index with pain and knee score at the latest follow-up, the average knee scores in normal and overweight group were found to be significantly higher than those in the obese group. The diabetic patients had an increased overall incidence of postoperative complications (17.6%) compared with the control group (8.1%) (p < 0.05). Particularly, the rate of wound complications such as skin necrosis, bulla formation or erythema with drainage was higher in the diabetic group (p < 0.05). Diabetes-related factors did not influence the incidence of complications. Associated diseases were the only significant risk factors correlated with wound complications and meniscal bearing dislodgement. CONCLUSION: Patients with diabetes can benefit from TKA, even though diabetic patients are at an increased risk for overall postoperative and wound complications. Preoperative factors such as obesity and associated diseases may adversely affect the clinical outcome of TKA in diabetic patients.     

The cutaneous silent period in diabetes mellitus

The cutaneous silent period (CSP) may be useful as a method for the evaluation of smaller and unmyelinated fiber dysfunctions. CSP refers to the brief interruption in voluntary contraction that follows strong electrical stimulation of a cutaneous nerve. The aim the present study is to establish whether CSP can be instrumental in the determination of diabetic neuropathy. The nerve conduction studies and CSP evaluations were both used in patients with Diabetes Mellitus and control group. All patients were given clinical neurological examinations for the determination of small-fiber neuropathy (SFN). The CSP values for patients with SFN were compared with values of those without SFN. The nerve conduction velocities had changed unfavorably in diabetic patients. No median nerve CSP reponse could be obtained in two of the diabetic patients. CSP latency (84.6+/-14.0) in diabetics was longer than controls (76.2+/-13.1) (p=0.018). The duration of CSP was similar for the two groups (p=0.46). The CSP latency showed a correlation with routine nerve conduction studies. While the CSP latencies (86.7+/-15.8) of patients who were clinically diagnosed with SFN were similar to the latencies (81.3+/-10.4) of patients without SFN (p=0.606), the duration of CSP (44.6+/-13.7) in patients with SFN was shorter than the duration (55.3+/-12.2) in patients without SFN (p=0.012). These results indicate that even though the CSP does not provide any advantage over routine electrodiagnostic studies in determining diabetic neuropathy, still it may be a useful method for the early detection of diabetic SFN.     

糖尿病母亲与新生儿相关疾病发生情况分析

目的探讨母亲妊娠合并糖尿病对新生儿相关疾病发生情况的影响。方法选择35例妊娠合并糖尿病孕产妇,与35例非妊娠合并糖尿病孕产妇就新生儿相关疾病进行对比分析。结果妊娠合并糖尿病组巨大儿、肺部感染、高胆红素血症、代谢性酸中毒、低血糖等发病率均高于对照组,两组比较差异显著（P〈0.05）。结论妊娠合并糖尿病母亲所生新生儿相关疾病发生率明显增高,及时发现及时处理对新生儿预后有很大影响。