饮食干预对妊娠期糖尿病患者血糖控制及母婴结局的影响

目的 探讨饮食干预对妊娠期糖尿病（GDM）患者血糖控制及母婴结局的影响.方法 将80例GDM患者按数字表法随机分为观察组和对照组,各40例.对照组采用传统的围生保健,观察组在此基础上给予个体化的饮食干预策略.比较分析两组患者血糖控制情况及母婴结局.结果 观察组和对照组的糖化血红蛋白、产后空腹血糖和餐后2h血糖及胱抑素C值分别为（5.07±0.73）％和（5.07±0.73）％,（4.47±0.29） mmol/L和（5.31±0.64） mmol/L,（6.84±1.31） mmol/L和（8.45± 1.37） mmol/L,（1.11 ±0.32） mg/L和（1.76±0.44） mg/L,差异均有统计学意义（=5.38、6.91、7.81、3.45,均P＜0.05）;观察组妊娠期高血压疾病、剖宫产、产后出血发生率分别为5.0％、20.0％、7.5％,均显著低于对照组的22.5％、57.5％、30.0％（x2=5.16、11.85、6.65,均P＜0.05）;与对照组比较,观察组的围生儿在早产、巨大儿、新生儿低血糖的并发症方面均显著降低（x2 =3.91、4.50、4.02,均P＜0.05）.结论 GDM与妊娠结局密切相关,加强饮食干预可有效降低母婴并发症,改善围生儿预后.

Influence of early perinatal health care for the pregnancy outcome of gestational diabetes mellitus

Objective To explore the influence of early perinatal health care for the pregnancy outcome of gestational diabetes mellitus （GDM）.Methods 86 cases of GDM patients who received obstetrical examination and parturition were randomly divided into the two groups by random number table.The control group （n =43） was given traditional health education,and the observation group （n =43） was given early perinatal health care including diet control,proper exercise,mental health and drug therapy.The blood sugar control situation and pregnancy outcome between the two groups were compared and analyzed.Results The fasting blood glucose and 2 hour post-meal blood sugar in the observation group were （5.07 ± 0.73） ％,（4.47 ± 0.29） mmol/L,（6.84 ± 1.31） mmol/L,（1.11 ±0.32） mg/L,which were significant lower than those of the control group （5.07 ± 0.73） ％,（5.31 ± 0.64） mmol/L,（8.45 ± 1.37） mmol/L,（1.76 ± 0.44） mg/L] （t =5.38,6.91,7.81,3.45,all P ＜ 0.05）.The incidence of preeclampsia,cesarean section,postpartum hemorrhage in the observation group were 5.0％,20.0％,7.5％,significant lower than those of the control group（22.5％,57.5％,30.0％） （x2 =5.16,11.85,6.65,all P ＜ 0.05）.Compared with the control group,the complication of premature delivery,fetal macrosomia,neonatal hypoglycemia for perinatal infant in the observation group were significantly reduced （x2 =3.91,4.50,4.02,all P ＜ 0.05）.Conclusion GDM is correlated with pregnancy outcome,strengthening early perinatal care can effectively reduce the mother infant complications and improve the perinatal prognosis.