血糖控制对妊娠期糖尿病患者妊娠结局的影响  

Effects of glycemic control for pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：张宣东[1] 张华[1] 蒋莉[1] 

机构地区：[1]解放军第四一一医院妇产科,上海200081

出　　处：《中国医药导报》2015年第12期89-92,96,共5页China Medical Herald

摘　　要：目的：探讨血糖控制对妊娠糖尿病患者妊娠结局的影响。方法选取2012年10月～2014年2月在解放军第四一一医院确诊为妊娠糖尿病的患者34例，对其积极采取心理护理、饮食管理、运动管理、胰岛素应用等综合治疗手段，以控制血糖。分娩前有26例患者糖化血红蛋白（HbA1c）水平≤6%，作为达标组，8例HbA1c〉6%，作为未达标组。选取同期的正常妊娠孕妇77例，作为正常组。观察三组孕妇酮症酸中毒、妊娠高血压、胎膜早破、羊水过多、产后出血及剖宫产等的发生情况。结果未达标组孕妇酮症酸中毒、妊娠高血压、胎膜早破、羊水过多、产后出血及剖宫产发生率均高于达标组及正常组（P〈0.05），未达标组新生儿的巨大儿、早产、高胆红素血症、新生儿窒息及新生儿低血糖发生率均高于达标组及正常组（P〈0.05）。结论妊娠糖尿病血糖控制可明显降低母婴并发症的发生率，有效改善妊娠结局。Objective To investigate of glycemic control for pregnancy outcomes in patients with gestational diabetes mellitus. Methods Thirty four cases of patients diagnosed as gestational diabetes mellitus in the 411st Hospital of PLA from October 2012 to February 2014 were chosen, and they were given active comprehensive treatment of psychological care, diet management, sports management, insulin use and other means, so as to control blood sugar. Before delivery, 26 patients with glycosylated hemoglobin （HbA1c） levels≤6% were taken as standard group, 8 cases with HbA1c〉6%were taken as substandard group. 77 cases of normal pregnant women at the same time were selected as normal group. The incidence of ketoacidosis, pregnancy-induced hypertension, premature rupture of membranes, polyhydramnios, postpartum hemorrhage, and cesarean section among the three groups were observed. Results The incidence of ketoacidosis, pregnancy-induced hypertension, premature rupture of membranes, polyhydramnios, postpartum hemorrhage, and cesarean section of substandard group were higher than those of standard group and normal group （P〈0.05）. The incidence of macrosomia, premature delivery, hyperbilirubinemia, neonatal asphyxia, neonatal hypoglycemia of substandard group were all higher than those of standard group and normal group （P〈 0.05）. Conclusion The glycemic control of gestational diabetes mellitus can significantly reduce the incidence of maternal complications, effectively improve pregnancy outcomes.

关 键 词：妊娠糖尿病 血糖控制 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]