妊娠期糖尿病治疗干预对妊娠结局的影响

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1、妊娠期糖尿病治疗干预对妊娠结局的影响杜昂鹰1，杜晓红2，郑淑娟3作者单位：四川省妇幼保健院（四川成都610021）摘要：目的：探讨妊娠期糖尿病（GDM）新诊断标准实施以来GDM流行病学分析及治疗干预措施对妊娠结局的影响。方法：回顾性分析2011-4-1至2012-8-1之间至本院就诊的妊娠期糖尿病患者病历资料。根据是否接受正规血糖监测及治疗分为治疗组及对照组。对比两组不良妊娠结局发生率之间的差异。结果：共计964名妊娠期糖尿病患者纳入研究，治疗组506人，对照组458人。治疗组中孕妇体重增长明显低于对照组；不良妊娠结局发病率（巨大儿，新生儿呼吸窘迫综合症，产后高胆红素血症，子痫前

2、期，产程异常，胎膜早破，早产，产后感染）明显低于于对照组。结论：新标准实施后GDM发病率明显增高。针对新标准下GDM孕妇采取更简洁的血糖监测仍是有效的，GDM正规治疗明显降低巨大儿，胎膜早破，早产，产程延长，子痫前期等并发症发病率；显著降低孕妇体重增长及胎儿体重增长。关键词：妊娠期糖尿病治疗妊娠结局EffectsoftreatmentsforgestationaldiabetesmellitusonperinataloutcomesDuAngying,DuXiaohong,ZhengShujuanSichuanprovincialHospitalofWomenandChildre

3、n’sHealth,Chengdu610021,Sichuanprovince,ChinaAbstracts:objects:TostudytheGestationaldiabetesmellitus(GDM)epidemiologyandtheeffectsofinterventioninpregnancyonperinataloutcomessincethenewcriteriaofdiagnosisofGDMcarryingout.Methods:Thiswasaretrospectivecase-basedstudy.964PatientswithGDMdelivered

4、inthetertiaryobstetrichospitalfrom1stApril2011to1stAugust2012enrolledinthestudy.TheperinataloutcomesofPatientsreceivedregularbloodglucosemonitoringandglucosecontrolintervention(interventiongroup,n=506)comparedwithpatientsreceivedroutineprenatalcareonly(controlgroup,n=458).Results:Theweightgai

5、nofthepatientsintheinterventiongroupwaslowerthanthecontrolgroup.Theratesofpregnancycomplications(Macrosomia;Respiratorydistresssyndrome;hyperbilirubinemia;preeclampsia,abnormallabor,prematureruptureofmembranes,pretermdelivery,postpartuminfection)intheinterventiongroupwerelowerthancontrolgroup

6、.Conclusion:TheincidenceofGDMincreasedsignificantlyafterthenewcriteriaofGDMdiagnosiscarryingout.Lessintensiveglucosemonitoringwasstilleffectiveandprobablymorefeasible.TheinterventionofGDMdecreasedtheratesofpregnancycomplications(Macrosomia;Respiratorydistresssyndrome;hyperbilirubinemia;preecl

7、ampsia,abnormallabor,prematureruptureofmembranes,pretermdeliveryandpostpartuminfection)andweightgainofpregnancywomenandoffspring.Keywords:Gestationaldiabetesmellitus,intervention,perinataloutcomes引言：妊娠期糖尿病(GDM)是指在妊娠期首次诊断的糖尿病.妊娠期糖尿病可导致多种不良妊娠结局