妊娠期糖代谢受损分娩前随访干预模式探讨和母婴结局分析  

Follow up and intervention mode of gestational carbohydrate metabolism abnormity before delivery and pregnant outcome analysis of mothers and babies

作　　者：李红 赵欣 郭玉娜 

机构地区：[1]上海市普陀区妇婴保健院,200060

出　　处：《上海医学》2009年第5期397-399,共3页Shanghai Medical Journal

基　　金：普陀区卫生系统优秀学科带头人培养计划资助课题

摘　　要：目的探讨妊娠期糖代谢受损分娩前随访干预模式和母婴结局。方法前瞻性研究213例妊娠期糖代谢受损患者(干预研究组),产前行血糖、血脂、胰岛素、糖化血红蛋白(HbA1c)和果糖胺测定以及眼底检查,专人进行饮食和锻炼指导,必要时应用胰岛素治疗,进行母胎监护和产科干预。639例同期正常妊娠妇女作为正常对照组,仅在普通门诊接受常规检查的69例妊娠期糖代谢异常患者作为干预对照组。结果干预研究组的妊娠期高血压疾病、巨大儿、胎膜早破、早产、胎儿窘迫、剖宫产构成比均显著高于正常对照组(P值均<0.01)。干预研究组与干预对照组巨大儿构成比的差异无统计学意义(P>0.05),而产后出血、剖宫产构成比则显著低于干预对照组(P值均<0.05)。结论对于妊娠期糖代谢受损患者要充分加强分娩前随访干预措施,对于改善母婴妊娠结局效果显著。Objective To explore the follow up and intervention mode of gestational carbohydrate metabolism abnormity before delivery and analyse the outcomes of mothers and babies. Methods A prospective study was carried out on 213 women （intervention group） with gestational carbohydrate metabolism abnormity. We examined the blood glucose, lipid, insulin, HbA1c, fructosamine（FRUCT） and eye fundus of the patients before delivery. The patients were given diet and exercise guidance in person; insulin injection was given when necessary. The mothers and fetuses were monitored and were given obstetric intervention. A total of 639 normal pregnant women at the same time were taken as normal control. Sixty-nine carbohydrate metabolism abnormity patients who received routine examination during Jan. 2001 to Dec. 2003 were taken as interventional control. Results The incidences of hypertension, macrosomia, premature rupture of membranes, premature delivery, fetal distress, and cesarean section in intervention group were significantly higher than that of the normal control group （P〈0.01）. The incidences of macrosomia were similar between the intervention group and the intervention control group. The incidences of postpartum hemorrhage and cesarean section in the intervention group were significantly lower than those in the intervention control group （P〈0.05）. Conclusion Follow up and intervention mode of gestational carbohydrate metabolism abnormity before delivery should be strengthened in women with gestational carbohydrate metabolism abnormity, which can effectively improve pregnant outcome of mothers and babies. （Shanghai Med J, 2009, 32= 397-399）

关 键 词：妊娠期糖代谢受损 妊娠期糖尿病 妊娠期糖耐量减低 随访干预模式 

分 类 号：R714.2[医药卫生—妇产科学] R587.1[医药卫生—临床医学]