妊娠期糖尿病一日门诊与妊娠不良结局的关系分析  

Analysis of the relationship between one-day outpatient service for gestational diabetes and adverse pregnancy outcomes

作　　者：初琦[1] 谭育松[1] 阴春霞[1] 鲍宏宇[1] 白宇[1] 姜巍 葛晨蕾[2] 刘洋 CHU Qi;TAN Yu-Song;YIN Chun-Xia(Changchun Maternal and Child Health Hospital,Changchun Maternity Hospital,Changchun,Jilin 130042,China)

机构地区：[1]长春市妇幼保健院长春市妇产医院,吉林长春130042 [2]吉林省人民医院,吉林长春130021 [3]东丰县妇幼保健计划生育服务中心,吉林东丰136300

出　　处：《中国妇幼保健》2022年第23期4335-4338,共4页Maternal and Child Health Care of China

基　　金：吉林省卫生厅科研课题(2011R025)。

摘　　要：目的 通过对妊娠期糖尿病(GDM)患者进行“一日门诊”管理,分析其与妊娠不良结局的关系。方法 选取2020年10月—2022年1月在长春市妇幼保健院分娩未应用胰岛素进行治疗的GDM患者276例为研究对象,将在本院糖尿病“一日门诊”进行管理的172例GDM患者设为观察组,在一般营养门诊咨询,未进行系统管理的GDM患者104例设为对照组。比较两组患者妊娠期高血压疾病的发病率、分娩前BMI、空腹和餐后2 h血糖、糖化血红蛋白、分娩方式及产后出血情况,并比较两组新生儿体质量、出生后血糖情况。结果 观察组患者妊娠期高血压疾病发病率(5.23%,9/172)明显低于对照组(15.38%,16/104),差异有统计学意义(χ~2=8.11,P<0.05)。观察组患者入院时BMI明显低于对照组,差异有统计学意义(P<0.05)。观察组患者入院后血清中空腹血糖[(4.70±0.25)mmol/L]、餐后2 h血糖[(5.80±0.87)mmol/L]及糖化血红蛋白[(5.40±0.33)%]水平均明显低于对照组[(5.30±0.47)mmol/L、(7.10±0.94)mmol/L及(5.70±0.51)%],差异均有统计学意义(t=13.84、6.00及5.88,均P<0.05)。观察组患者产后出血率(4.65%)、剖宫产率(28.49%)及阴道助产率(2.91%)均明显低于对照组(14.42%、45.19%及9.62%),差异均有统计学意义(χ~2=8.10、7.88及5.66,均P<0.05)。观察组新生儿巨大儿发生率(4.65%)和低血糖发生率(2.91%)均明显低于对照组(30.77%、11.54%),差异均有统计学意义(χ~2=18.01、6.93,均P<0.05)。结论 通过GDM“一日门诊”的管理,明显降低GDM患者妊娠不良结局发生率。Objective To analyze the relationship between pregnancy diabetes mellitus(GDM) and adverse pregnancy outcomes through one-day outpatient management.Methods 276 GDM patients who were delivered in Changchun maternal and child health hospital from October 2020 to January 2022 and were not treated with insulin were selected as the study objects. 172 GDM patients who were managed in the "one-day outpatient clinic" of diabetes in our hospital were set as the observation group, and 104 GDM patients who were not systematically managed in the general nutrition outpatient consultation were set as the control group. The incidence rate of hypertensive disorder complicating pregnancy, BMI before delivery, fasting and 2 h postprandial blood glucose, glycosylated hemoglobin, mode of delivery and postpartum hemorrhage were compared between the two groups, and the body mass and postnatal blood glucose of newborns were compared between the two groups.Results The incidence rate of hypertensive disorder complicating pregnancy in the observation group(5.23%, 9/172) was significantly lower than that in the control group(15.38%, 16/104),and the difference was statistically significant(χ ~2=8.11,P<0.05). The BMI of the patients in the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05). The levels of fasting blood glucose [(4.70±0.25) mmol/L],2 h postprandial blood glucose [(5.80±0.87)mmol/L] and glycosylated hemoglobin [(5.40±0.33)%] in the observation group were significantly lower than those in the control group [(5.30±0.47)mmol/L,(7.10±0.94)mmol/L and(5.70±0.51)%] after admission, and the differences were statistically significant(t=13.84,6.00 and 5.88,P<0.05). The postpartum hemorrhage rate(4.65%), cesarean section rate(28.49%) and vaginal midwifery rate(2.91%) in the observation group were significantly lower than those in the control group(14.42%, 45.19% and 9.62%),and the differences were statistically significant(χ~2=8.10,7.88 and 5.66,P<0.05

关 键 词：妊娠期糖尿病 一日门诊 妊娠不良结局 

分 类 号：R587.1[医药卫生—内分泌]