个体化营养疗法对妊娠糖尿病血糖控制及妊娠结局的影响  

Influence of individual nutrition therapy on blood glucose control and pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：胡彩霞[1] 谭建琴[1] 沈丽君[1] 何芸萍 

机构地区：[1]杭州市余杭区妇幼保健院,浙江杭州311100

出　　处：《中国妇幼健康研究》2015年第6期1286-1288,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探索个体化营养疗法对妊娠糖尿病(GDM)患者血糖控制以及妊娠结局的影响。方法将杭州市余杭区妇幼保健院确诊的180例GDM患者采用随机数字表法分成两组,其中对照组90例予一般饮食指导,治疗组90例予个体化营养疗法,比较患者血糖控制情况及妊娠结局差异。结果治疗组患者经治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)和糖化血红蛋白为HbA1e均较对照组明显降低(t值分别为6.88、7.32、7.93,均P<0.05),FPG达标、早餐后2hPG达标、午餐后2hPG达标和晚餐后2hPG达标均较对照组明显升高(x^2值分别为10.54、9.34、8.65、7.23,均P<0.05)。治疗组产妇孕期体重增长值、新生儿出生体重均较对照组明显降低(t值分别为6.76、7.54,均P<0.05)。两组胎儿窘迫、新生儿窒息发生率比较无显著性差异(x^2值分别为1.10、0.02,均P>0.05),但治疗组早产、剖宫产、巨大儿发生率均较对照组明显降低(x^2值分别为9.65、8.34、10.65,均P<0.05)。结论个体化营养疗法能够控制GDM患者血糖水平,维持其孕期体重和新生儿体重,且有利于改善妊娠结局,对临床借鉴应用和广泛推广有实际意义。Objective To explore the influence of individual nutrition therapy on blood glucose control and pregnancy outcomes of patients with gestational diabetes mellitus （GDM）. Methods Totally 180 cases of GDM selected in the study from Maternal and Child Health Hospital of Yuhang District in Hangzhou were divided into two groups using random number table method, control group （90 cases） treated with general diet instruction and treatment group （90 cases ） treated with individualized nutrition therapy. The blood glucose control and outcomes of pregnancy of two groups were compared. Results After treatment, FPG, 2hPG and HbAIc of the treatment group were significantly lower than those in the control group （ t value was 6.88, 7.32 and 7.93, respectively, all P 〈 0.05 ） , but FPG reaching standards, 2hPG reaching standards after breakfast, 2hPG reaching standards after lunch, 2hPG reaching standards after dinner were more remarkable in the treatment group （X2 value was 10.54, 9.34, 8.65 and 7.23, respectively, all P 〈 0.05）. In the treatment group, maternal weight gain and birth weight decreased more significantly than in the control group （t value was 6.76 and 7.54, respectively, both P 〈 0.05）. The incidence rate of fetal distress and neonatal asphyxia was not significantly different between two groups （2 value was 1.10 and 0.02, respectively, both P 〉 0.05 ）, but in the treatment group the incidence of preterm labor, cesarean section and fetal macrosomia was significantly lower （X2 value was 9.65, 8.34 and 10.65, respectively, all P 〈 0.05 ）. Conclusion Individual nutrition therapy is effective in controlling blood glucose in patients with GDM and maintaining maternal and neonatal weight. It is conducive to improve pregnancy outcomes and is of practical importance in clinical reference popularizing and applying.

关 键 词：个体化营养疗法 妊娠糖尿病 血糖控制 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]