高压氧对妊娠期糖尿病围产结局的影响

目的:探讨高压氧(HBO)疗法对妊娠期糖尿病围产结局的影响。方法:选择180例妊娠28周诊断为糖尿病的孕妇,根据自愿的原则,按就诊顺序随机分为:治疗组90例,采用胰岛素加高压氧治疗;对照组90例,采用胰岛素加鼻导管给氧。疗程结束检测胎儿脐动脉血流速率在收缩期末和舒张期末的比值(S/D)、搏动指数、阻力指数测定,比较两组脐动脉血流值,并随访分娩结局。结果:①治疗组的S/D值、搏动指数及阻力指数分别为1.45±0.22,0.86±0.05,0.32±0.17,对照组分别为2.55±0.52,1.53±0.23,0.59±0.68,两组比较差异均有统计学意义(P<0.01)。②治疗组胎膜早破、早产、巨大儿发生率分别为6.7%、4.5%、5.6%,对照组分别为17.8%、15.6%、18.9%,两组比较差异均有统计学意义(P<0.05)。结论:高压氧治疗围产期妊娠期糖尿病胎儿宫内缺氧的疗效肯定,安全无创值得推广。

The influence of hyperbaric oxygen to the pregnancy outcome of pregnancy women with gestational diabetes mellitus

Objective:To study the influence of hyperbaric oxygen(HBO) to the pregnancy outcome of pregnancy women with gestational diabetes mellitus(GDM). Methods:A total of 180 pregnancy women who were diagnosed GDM at 28th weeks were divided into two groups according to the principle of voluntariness and the doctor order randomly.The women of treatment group(90 cases) were given insulin and HBO treatment;the women of observation group(90 cases) were given insulin and nasal catheter oxygen inhalation treatment.At the end of treatment,the S/D value of fetal umbilical artery blood flow,pulsatile index(PI),resistance index(RI) and the value of umbilical arterial blood flow were measured and compared,the outcomes of pregnant women and neonates were analyzed. Results:① In treatment group,S/D,PI,RI were1.45±0.22,0.86±0.05,0.32±0.17 absolutely;in observation group were 2.55±0.52,1.53±0.23,0.59±0.68 absolutely,there were significantly statistical differences between the two groups(P<0.01).② In treatment group,the incidences of premature rupture of membrane,premature infant,macrosomia were 6.7%,4.5%,5.6% absolutely;in observation group were 17.8%,15.6%,18.9%,there were statistical differences between the two groups(P<0.05). Conclusion:Insulin and HBO treatment to fetal hypoxia of pregnant women with GDM is effective,safe and noninvasive,it is worthy to be popularized.