胰岛素泵持续治疗妊娠期糖尿病对孕妇和围产儿影响的护理研究  

Nursing Research continuous insulin pump therapy in pregnant women with gestational diabetes and perinatal impact

作　　者：阳爱芳 陈慧 唐启斌 杨梅 张永顺 谭力学 

机构地区：[1]广东省东莞市常平医院内分泌科,广东东莞523573

出　　处：《中国医药科学》2015年第2期116-119,共4页China Medicine And Pharmacy

摘　　要：目的探讨胰岛素泵持续皮下注射胰岛素治疗妊娠期糖尿病对孕妇和围产儿的影响及其临床意义。方法将GDM按随机数字表法分为胰岛素泵持续皮下输注胰岛素组(CSII组)和常规皮下注射胰岛素组(MSII组)两组,各组患者均为30例。两组患者均予以常规饮食和运动治疗,CSII组采用胰岛素泵持续皮下输注胰岛素治疗;MSII组采用常规皮下注射胰岛素治疗。观察比较两组患者孕期及产期血压、血脂、平均血糖、餐后2h血糖、Hb A1C,空腹血糖、空腹胰岛素、HOMA-IR的变化及妊娠并发症以及巨大儿、新生儿低血糖及胎儿窘迫例数及发生率。结果两组在年龄、入组孕周、血糖及体重指数等方面差异均无统计学意义(P>0.05),而经治疗后CSII组平均血糖值、餐后2h血糖、Hb A1C,空腹血糖低,妊高症、先兆子痫、酮症酸中毒、早产、剖宫产、死产、孕妇低血糖、产伤或肩难产、羊水过多、FGR、巨大儿、新生儿低血糖及胎儿窘迫发生率低,且分娩孕周晚,两组比较差异有统计学意义(P<0.05)。结论胰岛素泵持续皮下输注胰岛素组(CSII组)比常规皮下注射胰岛素组(MSII组)治疗妊娠期糖尿病降糖效果好,可延长孕周,妊娠并发症以及巨大儿、新生儿低血糖及胎儿窘迫发生率低,对于安全、有效地治疗妊娠期糖尿病,控制血糖达标,减少孕期并发症,改善围产儿结局,改善新生儿预后具有深远的临床意义。Objective To investigate the continuous subcutaneous insulin infusion pump（CSII） therapy and clinical significance of gestational diabetes in pregnant women and perinatal. Methods GDM were randomly divided into continuous subcutaneous insulin infusion group（CSII group） and conventional subcutaneous insulin group（MSII group）,30 cases in each group.All patients received routine diet and exercise therapy,CSII group received continuous subcutaneous insulin infusion insulin pump therapy;MSII group received conventional subcutaneous insulin therapy.Pregnancy and childbirth blood pressure,lipids,average blood glucose,2h postprandial blood glucose,Hb A1 C,fasting glucose,fasting insulin,HOMA-IR changes and pregnancy complications,and great children,neonatal hypoglycemia and cases of fetal distress the number and incidence between the two groups of patients were compared. Results The difference between the two groups in terms of age,the group of gestational age,blood glucose and body mass index were not statistically significant（P〉0.05）,and in CSII group,the average blood glucose,2h postprandial blood glucose,Hb A1 C,fasting blood sugar were lower,the rate of pregnancy-induced hypertension,preeclampsia,ketosis,premature birth,cesarean delivery, stillbirth,maternal hypoglycemia,shoulder dystocia or birth trauma,excessive amniotic fluid,FGR,great children,neonatal hypoglycemia,and fetal distress were lower,and gestational age was late,the difference between the two groups was statistically significant（P〈0.05）. Conclusion Hypoglycemic effect of gestational diabetes treatment in the CSII group is better than that in MSII group,it can prolong gestation,the rate of pregnancy complications,and great children,neonatal hypoglycemia and fetal distress is low,is safe,effective treatment of gestational diabetes,blood glucose control,reduce pregnancy complications and improve perinatal outcomes,improve neonatal outcomes with far-reaching significance.

关 键 词：妊娠期糖尿病 胰岛素泵 胰岛素 孕期并发症 围产儿 护理 

分 类 号：R714.7[医药卫生—妇产科学]