妊娠合并糖代谢异常孕妇产程中血糖监测的前瞻性研究

目的　探讨妊娠合并糖代谢异常孕妇在产程中行血糖监测和处理后对新生儿血糖变化的影响。方法　选择妊娠合并糖代谢异常孕妇 4 0例 ,其中妊娠期糖尿病孕妇 30例 ,糖耐量低减孕妇8例 ,糖尿病合并妊娠孕妇 2例。产程中对其进行血糖动态监测 ,血糖异常者及时使用低剂量短效胰岛素静脉滴注 ,观察分娩后新生儿的血糖水平变化。结果　产程中糖代谢异常孕妇的血糖波动范围为 3 8～ 11 2mmol/L。其中 ,17例进行了胰岛素静脉滴注 (胰岛素用量范围为 1 5～ 3 0U) ,占糖代谢异常孕妇总数的 4 2 5 % (17/40 ) ,分娩后新生儿即刻血糖水平平均为 (4 0± 1 5 )mmol/L ,分娩后 2 4h的新生儿血糖水平为 (3 9± 1 0 )mmol/L ,发生新生儿低血糖 2例 ;2 3例未用胰岛素孕妇的新生儿生后即刻血糖水平平均为 (4 2± 1 5 )mmol/L ,分娩后 2 4h的新生儿血糖水平为 (3 9± 1 0 )mmol/L ,发生新生儿低血糖 1例。结论　妊娠合并糖代谢异常孕妇 ,在产程中行血糖监测和控制 ,可避免新生儿低血糖的发生。

Study on controlling the blood glucose level of gestational diabetes mellitus sufferer regularly during labor

OBJECTIVE: To study the maternal blood glucose management of gestational diabetes mellitus during the labor and relationship of maternal blood glucose in labor and neonatal blood sugar. METHODS: A prospective study on maternal blood glucose monitoring and control during labor was carried in 40 pregnant women with abnormal glucose metabolism. We adjusted maternal blood glucose by low-dosage constant insulin drop during labor. RESULTS: Maternal blood glucose in labor arranged between 3.8 approximately 11.2 mmol/L, and low-dosage constant insulin drop was used in 17 cases (42.5%). The neonatal blood glucose was (4.0 +/- 1.5) mmol/L following delivery and (3.9 +/- 1.0) mmol/L at 24-hour postpartum. There were 2 cases with neonatal hypoglycemia. The neonatal blood glucose of the rest 23 cases was (4.2 +/- 1.5) mmol/L, and (3.9 +/- 1.0) mmol/L at 24-hour postpartum, and 1 case with neonatal hypoglycemia. There was no the difference of the blood glucose level of newborns between mothers with abnormal glucose metabolism and the normal pregnant women. CONCLUSION: It is necessary to monitor and control the blood glucose level by low dose constant insulin during labor in pregnant women with abnormal glucose metabolism.