妊娠期糖尿病的管理模式及对母婴结局的影响

目的探讨妊娠期糖尿病的孕期管理模式及其对孕妇和围生儿的影响，为妊娠期糖尿病的干预提供科学依据。方法选择确诊的妊娠期糖尿病患者120例，其中75例作为干预研究组由专人进行饮食和锻炼指导，必要时应用胰岛素治疗，并进行母胎监护和产科干预；另外45例为干预对照组在孕期未采用综合的孕期管理干预；选取同期在该医院住院分娩的血糖正常100例孕妇作为正常对照组；比较三组产妇的母婴结局。结果干预研究组的妊娠期高血压疾病、胎膜早破、早产、胎儿窘迫的发生率与正常对照组相比差别无统计学意义（P〉O．05），但是巨大儿、剖宫产的发生率高于正常对照组（P〈0．05）。干预研究组的妊娠期高血压疾病、胎膜早破、早产、胎儿窘迫、巨大儿、剖宫产率均低于干预对照组（P〈O．05）。结论加强妊娠期糖尿病孕期的系统管理，可使母婴并发症的发生率明显降低，甚至接近于正常孕妇水平。

Management Mode of Gestational Diabetes Mellitus and Pregnant Outcome of Mothers and Babies

Objective To explore the management mode of gestational diabetes mellitus （GDM）and pregnant outcome of mothers and babies,and to supply the basis for shaping the intervention strategy. Methods 120 cases with GDM were selected,among of them 75 pregnant women （intervention group）were given diet and exercise guidance in person,insulin injection were given when necessary and the mothers and fetuses were monitored and were given obstetric intervention,the other pregnant women who received routine examination were taken as interventional control. A total of 100 normal pregnant women at the same time and same hospital were taken as normal control. Results The incidence of hypertension,premature rupture of membranes,premature dehvery and fetal distress in intervention group have no difference significantly with that in normal control group （P〉O.OS）,bnt the rate of macrosomia and cesarean section in intervention group were higher significantly than that in normal control group （P〈O.05）. The incidence of hypertension,premature rupture of membranes,premature delivery,fetal distress,macrosomia and cesarean section in intervention group were lower significantly than that in intervention control group （P~0.05）. Conclusion The incidence of complications among maternal and child can significantly be lower by strengthening the management of GDM,and even close to the level of normal pregnant women.