早期胰岛素治疗方案对于妊娠期糖尿病患者妊娠结局的影响  

The Effect of Early Insulin Treatment Regimen on Pregnancy Outcomes in Gestational Diabetes Mellitus Patients

作　　者：宋飞 SONG Fei(Department of Internal Medicine,Linzi District Maternal and Child Health Hospital,Zibo,Shandong Province,255400 China)

机构地区：[1]临淄区妇幼保健院内科,山东淄博255400

出　　处：《糖尿病新世界》2023年第21期103-106,共4页Diabetes New World Magazine

摘　　要：目的探讨早期胰岛素治疗方案对于妊娠期糖尿病(gestational diabetes mellitus,GDM)患者妊娠结局的影响。方法回顾性分析2020年11月—2021年10月于临淄区妇幼保健院就诊的98例GDM患者的临床资料。根据胰岛素启动治疗的妊娠时间进行分组,即早期组(妊娠<32周启动胰岛素治疗)50例与晚期组(妊娠≥32周启动胰岛素治疗)48例。两组患者确诊后均予以饮食与运动干预,并使用胰岛素治疗。比较两组患者就诊时与分娩前1周的血糖水平,以及两组患者妊娠结局与新生儿结局。结果分娩前1周,两组患者餐后2 h血糖、空腹血糖水平对比,差异无统计学意义(P>0.05)。与晚期组相比,早期组早产、羊水过多的发生率更低,差异有统计学意义(P<0.05);两组患者剖宫产、妊娠期高血压疾病发生率对比,差异无统计学意义(P>0.05)。与晚期组相比,早期组新生儿低血糖、巨大儿的发生率更低,差异有统计学意义(P<0.05);两组新生儿窒息、高胆红素血症发生率对比,差异无统计学意义(P>0.05)。结论胰岛素治疗方案能够有效控制GDM患者的血糖水平,而早期胰岛素治疗进一步保障了妊娠结局与新生儿结局。Objective To investigate the effect of early insulin treatment regimen on pregnancy outcomes in gesta-tional diabetes mellitus(GDM)patients.Methods The clinical data of 98 cases of GDM treated in Linzi District Mater-nal and Child Health Hospital from November 2020 to October 2021 were retrospectively analyzed.According to the gestation time of insulin initiation,50 cases were in the early group(islet initiation at<32 weeks gestation)and 48 cases in the late group(insulin initiation at≥32 weeks gestation).After diagnosis,both groups were given diet and ex-ercise intervention,and insulin treatment.Blood glucose levels were compared between the two groups at the time of visit and 1 week before delivery,as well as pregnancy and neonatal outcomes in both groups.Results One week be-fore delivery,there was no statistically significant difference in the levels of blood glucose and fasting blood glucose at 2-hour postprandial between the two groups(P>0.05).The incidence of premature delivery and excessive amniotic fluid in the early group was lower than that in the late group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of cesarean section and pregnancy-induced hyperten-sion between the two groups(P>0.05).Compared with the late group,the incidence of neonatal hypoglycemia and mac-rosomia was lower in the early group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of neonatal asphyxia and hyperbilirubinemia between the two groups(P>0.05).Conclusion Insulin treatment regimen can effectively control the blood glucose level of GDM patients,while early in-sulin treatment further guarantees the pregnancy outcome and neonatal outcome.

关 键 词：早期 胰岛素 妊娠期糖尿病 妊娠结局 

分 类 号：R587[医药卫生—内分泌]