妊娠合并糖尿病的诊治体会及管理现状的思考  

Thoughts on the Diagnosis and Treatment of Pregnancy Complicated with Diabetes Mellitus

作　　者：宋岚[1] SONG Lan(Department of Internal Medicine,Yangzhou Maternal and Child Health Hospital,Yangzhou,Jiangsu Province,225002 China)

机构地区：[1]江苏省扬州市妇幼保健院内科,江苏扬州225002

出　　处：《中外医疗》2018年第34期74-76,共3页China & Foreign Medical Treatment

摘　　要：目的该文重点研究妊娠合并糖尿病使用不同种类胰岛素治疗的疗效、安全性及影响因素,并探讨对此类患者孕期全程管理模式的改进。方法方便选取2017年1—12月诊治的138例患者,随机分为对照组和研究组,每组69例;对照组采用精蛋白生物合成人胰岛素(预混30R)进行治疗,研究组采用门冬胰岛素联合地特胰岛素进行治疗;对比两组患者各项血糖指标,低血糖发生率,治疗依从性。结果研究组的空腹血糖、餐后2 h血糖、血糖达标时间等指标优于对照组,差异有统计学意义(t=3.733 2,3.920 2,3.228 1,P=0.000 3,0.000 1,0.001 6),低血糖发生率(2.89%)低于对照组(8.69%),患者依从性(94.20%)高于对照组(79.71%),差异有统计学意义(χ~2=6.272 7,6.388 9,P=0.012 2, 0.0114,P<0.05)。结论妊娠合并糖尿病的高血糖控制受多方面因素影响,药物首选胰岛素,门冬胰岛素联合地特胰岛素具有很好的疗效及安全性,患者依从性更高;同时,对药物疗效及安全性的影响除了药物本身因素外,还有其它因素参与,故强调妊娠合并糖尿病的诊治是多学科协作的综合管理,必须全程监督,优化现有的管理流程。Objective To investigate the efficacy,safety and influencing factors of different types of insulin therapy in pregnancy with diabetes,and to explore the improvement of the whole process management mode of these patients during pregnancy.Methods A total of 138 patients were conveniently enrolled from January to December 2017.They were randomly divided into the control group and the study group,with 69 patients in each group.The control group was treated with protamine biosynthesis human insulin (premixed 30R).Insulin aspart and Detemir was used for treatment;blood glucose levels,hypoglycemia rate,and treatment compliance were compared between the two groups.Results The fasting blood glucose,postprandial 2h blood glucose,and blood glucose compliance time of the study group were better than those of the control group.The difference was statistically significant(t=3.733 2,3.920 2,3.228 1,P=0.000 3,0.000 1,0.001 6,and hypoglycemia occurrance rate (2.89%) was lower than that of the control group (8.69%),and the patient compliance (94.20%) was higher than that of the control group (79.71%).The difference was statistically significant(χ^2=6.272 7,6.388 9,P=0.012 2,0.011 4,P<0.05).Conclusion Hyperglycemia control in pregnancy with diabetes is affected by many factors.The insulin is the first choice for insulin.Insulin aspart and insulin detemir have good efficacy and safety,and patients have higher compliance.At the same time,the effect on drug efficacy and safety.In addition to the factors of the drug itself,there are other factors involved,so it is emphasized that the diagnosis and treatment of pregnancy with diabetes is a comprehensive management of multidisciplinary collaboration,and it is necessary to supervise and optimize the existing management process.

关 键 词：妊娠合并糖尿病 门冬胰岛素 地特胰岛素 精蛋白生物合成人胰岛素(预混30R) 综合管理 

分 类 号：R714.256[医药卫生—妇产科学]