个性化营养支持治疗在妊娠期糖尿病患者治疗中的意义  

Effects of individualized nutritional support therapy on the patients with gestational diabetes mellitus

作　　者：孙影[1] 吴艳芳[1] 李秀琴[1] 吴亚雪[1] 

机构地区：[1]海军总医院妇产科,北京100048

出　　处：《转化医学杂志》2013年第5期300-302,共3页Translational Medicine Journal

摘　　要：目的探讨个性化营养支持治疗对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者分娩结局以及糖代谢的影响。方法 2012年4月—2013年3月在海军总医院正规产检和分娩的224例GDM患者,严格进行个性化营养支持治疗的为治疗组,未进行正规治疗的为未治疗组,分析比较两组间分娩结局(早产率、巨大儿发生率以及剖宫产率)的差异;对其中进行个性化营养支持治疗的143例GDM患者,监测治疗前后的空腹血糖以及餐后2 h血糖的变化。结果治疗组与未治疗组相比较:巨大儿发生率和剖宫产率明显降低,差异有统计学意义(P<0.05);早产率差异无统计学意义(P>0.05)。个性化营养支持治疗后空腹血糖、餐后2 h血糖均较治疗前明显下降,差异有统计学意义(P<0.001)。结论个性化营养支持治疗是GDM患者综合治疗方案的核心和基础,在此基础上严密监测血糖水平以及配合适当的运动,可以明显改善GDM患者糖代谢,降低空腹血糖以及餐后2 h血糖水平;同时,可以明显降低巨大儿的发生率,降低剖宫产率,改善分娩结局。Objective To discuss the effects of individualized nutritional support therapy to glyeometabolism of gestational diabetes mellitus patients and their pregnancy outcomes. Methods Two hundred twenty four cases of pregnant women with gestational diabetes mellitus with regular check-up and delivery in Navy General Hospital from April 2012 to March 2013 were divided into two groups. The patients who strictly carry out individualized nutritional support therapy were the treatment group, and those without formal treatment were untreated group. We compared the differences between the two groups （preterm birth rate, incidence of maerosomia and cesarean section rate）. Individualized nutritional support therapy given in 143 cases of gestational diabetes, the changes of the fasting blood glucose and the postprandial 2 hour blood glucose before and after the treatment were monitored. Results The incidence of macrosomia and cesarean section rate decreased in the treated group, the difference was statistically significant （P〈0.05）, but the premature delivery rate has no difference between the two groups. After the individualized nutritional support, fasting blood glucose and postprandial two hour blood glucose levels were significantly decreased than before （P〈 0.05 ）. Conclusion Individualized nutritional support therapy is the core and foundation of gesta- tional diabetes therapy, coordinating to closely monitor the blood glucose level and appropriatly exer- cise,can significantly improve the glucose metabolism in patients with GDM, reduce fasting blood glucose and 2 h postprandial blood glucose level, also reduce the occurrence rate of macrosomia, the cesarean section rate, and improve birth outcomes.

关 键 词：妊娠期糖尿病 个性化营养支持治疗 血糖 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]