妊娠糖尿病规范管理与妊娠结局

目的:探讨妊娠糖尿病(GDM)规范化管理的效果和妊娠结局的关系。方法:对56例GDM患者(研究组)进行规范管理,包括饮食调节、运动治疗、胰岛素治疗、糖尿病知识健康教育等;以1∶2比例选择同期该院非糖尿病孕妇112例作为对照。结果:①糖尿病相关知识知晓率由管理前的26.79%提高到管理后的85.71%,糖尿病对母儿危害的相关知识知晓率由管理前的10.71%提高到91.07%,P<0.01;②管理后血糖水平显著下降,自身对照P<0.01;③剖宫产、羊水过多发生率研究组高于正常对照组,P<0.01或P<0.05,妊高征、产后出血、产程延长、阴道助产、胎膜早破、巨大儿、新生儿高胆红素血症、新生儿呼吸窘迫综合征发生率组间比较差异无统计学意义,P>0.05。结论:①规范化管理可以使血糖良好控制,可提高孕妇对GDM相关知识的知晓率,提高管理依从性;②规范管理GDM孕妇可降低母儿并发症,获得与正常妊娠基本等同的妊娠结局。

Effect of standardized management of gestational diabetes mellitus on pregnancy outcomes

Objective:To investigate the relationship between the standardized management on gestational diabetes mellitus(GDM).and pregnancy outcomes.Methods:A total of 56 GDM women(study group)were performed standardized management,which was diet regulation,exercise,insulin therapy and diabetes education et al,and 112 cases non-diabetic pregnant women in our hospital during the same period were chosen by 1:2 ratio as a control group.Results:①Awareness rates of knowledge about diabetes mellitus before management was 26.79% and after management was 88.71%,awareness rates of knowledge on impacts of gestational diabetes mellitus on maternal and fetal was 10.71% before management and was 91.07% after management.②Plasma glucose(PG) level was significantly lower than that before management,P<0.01.③ The rates of abdominal delivery and hydramnion in study group were higher than that in control group,P<0.01 or P<0.05.There were not significant differences in the rates of pregnancy induced hypertension syndrome,postpartum hemorrhage,prolonged labor,assisted vaginal delivery,premature rupture of fetal membranes,macrosomia,neonatal hyperbilirubinemia,neonatal respiratory distress syndrome in the two groups(P>0.05).Conclusion:①Standardized management can ensure the well results of controlling hyperglycemia,and make GDM women to get more knowledge of diabetes mellitus,and can improve their compliance under management;②Standardized management can reduce complications of maternal and fetal,and get the same pregnancy outcomes as non-diabetic pregnant women.