妊娠期糖尿病孕妇产后糖代谢随访的依从性研究  

Glucose tolerance test follow-up survey of gestational diabetes in postpartum

作　　者：詹雁峰[1] 王子莲[1] 梁莹莹[1] 陈海天[1] 

机构地区：[1]中山大学附属第一医院妇产科,广州510080

出　　处：《现代妇产科进展》2007年第6期437-439,共3页Progress in Obstetrics and Gynecology

摘　　要：目的：探讨影响妊娠期糖代谢异常孕妇产后糖代谢的高危因素,以加强糖尿病孕妇产后的教育,提高产后糖代谢检查的随访率。方法：280例产前确诊为GIGT（gestational impaired glucose tolerance,GIGT）和GDM（gestational diabetes mellitus,GDM）的孕妇,通过宣教和书面嘱托,于分娩后6 ~8周回院行糖耐量试验,统计随访率,比较随访组与失访组的年龄、学历、家庭收入、分娩方式等指标,分析产后失访的高危因素。结果：280例中186例进行糖代谢检查,随访率为66.43%,失访率为33.57%。随访组和失访组分娩前的BMI（body mass indes,BMI）分别为27.28±3.07、26.96±2.79,诊断GDM孕周分别为29.29±3.58、30.12±4.36,使用胰岛素治疗者为3.76%、3.19%,分娩大于胎龄儿分别为5.56%、7.78%,上述指标两组差异无统计学意义。随访组31.7±4.02岁,本科以上学历40%,糖尿病家族史9.14%,剖宫产率85.48%,家庭月收入7.68±6.47千元,明显高于失访组的30.12±4.36岁、35%、4.26%、80.85%和6.85±3.23千元。随访组OGTT2h,血糖大于11.1mol/L者占11.29%,新生儿低血糖的发生率3.23%则低于失访组21.27%和9.57%。结论：医护人员在规范宣教GDM产后随访过程中,应对年轻的、本科以下学历的、无糖尿病家族史的GIGT和GDM孕妇加强产后糖代谢检查的宣教工作。Objective：To determine the influence glycometabolic risk factors of women with gestational abnormal glucose, and to provide the instruction for postpartum education and postpartum follow-up rate. Methods：With educational propaganda and writing inform, a total of 280 women of GDM were asked to come back to the hospital in 6 -8 weeks after delivery to perform oral glucose tolerance test （ OGTr）. In order to analyze the risk factors for GDM women who fail to follow-up. Age, educational background, family income and pregnancy outcome were compared in women follow-up and those who didn t. Results：One hundred and eighty-six GDM had come back in 6 -8weeks after delivery to carry out the OGTr,and the follow-up rate was 66.43%. There was no statistical difference between the follow-up group and those who failed in BMI before pregnancy（27.28 ± 3.07,26.96 ± 2.79 ）, diagnosis gestational week（ 29.29 ± 3. 58,30. 12 ± 4.36 ）, insulin therapy （ 3.76%, 3.19 % ）, and rate of deliver large for gestional age fetus（5.56% ,7.78% ）. The follow-up group had an average age 31.7 ± 4.02 ,college degree 40% ,family history of diabetes 9.14% ,ceraren section rate 85.48% ,family monthly income 7.68 ± 6.47 thonsand RMB, and all of them were significantly higher than those failed to follow-up as 30.12 ±4.36,35% ,4.26% ,80.85% and 6.85 ±3.23 thousand RMB. While 2 hour glucose level over 11.1 tool/L（ 11.29% ） ,and neonatal hypoglycemia（ 3.23% ） in the follow-up group was significantly lower than those who didnt（21.27% vs 9.57% ）. Conclusion： The educational propaganda should be reinforced for postpartum follow-up OGTr in those GDM women who are younger ,with lower education and without family diabetes history.

关 键 词：糖尿病 妊娠 产后期 糖耐量试验 

分 类 号：R714.256[医药卫生—妇产科学]