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目的探讨规范化干预治疗对妊娠期糖尿病(GDM)患者围产结局的影响及对产后3个月糖代谢转归的影响。方法选取2013年12月-2015年12月在该院治疗的124例GDM患者为研究对象,分为规范化治疗组(96例)与未规范化治疗组(28例)。回顾性分析两组人群产科并发症与新生儿并发症发生情况,分析产后1周及产后3个月时基本情况与血糖控制情况;探讨产后3个月糖代谢异常的影响因素。结果规范化治疗组剖宫产率、早产与羊水过多发生率、新生儿窒息、巨大儿、新生儿呼吸窘迫、新生儿高胆红素血症发生率均较未规范化治疗组显著降低,差异均有统计学意义(均P<0.05)。产后1周和产后3个月规范化治疗组空腹血糖水平、糖化血红蛋白水平及口服葡萄糖耐量2 h血糖水平均显著低于未规范化治疗组(P<0.05);规范化治疗组糖耐量受损发生率显著低于未规范化治疗组,差异有统计学意义(P<0.05)。孕期规范化治疗、产后母乳喂养及产后膳食干预均有助于糖代谢异常转归为正常水平;高血脂不利于血糖代谢异常的转归。结论 GDM患者孕期规范化治疗能够显著降低围生期母婴并发症,有利于改善妊娠结局、控制产后血糖及糖代谢异常的转归。
Objective To investigate the effect of standardized intervention on perinatal outcome in patients with gestational diabetes mellitus (GDM) and its effect on the outcome of 3 months postpartum glycometabolism. Methods A total of 124 GDM patients treated in our hospital from December 2013 to December 2015 were selected and divided into two groups: standardization treatment group (n = 96) and non-standardized treatment group (n = 28). Retrospective analysis of two groups of obstetric complications and complications of neonatal complications, 1 week after delivery and postpartum 3 months to analyze the basic situation and control of blood glucose; 3 months after delivery to investigate the impact of abnormal glucose metabolism factors. Results The rate of cesarean section, the incidence of preterm birth and amniotic fluid, the incidence of neonatal asphyxia, macrosomia, neonatal respiratory distress and neonatal hyperbilirubinemia in the standardization group were significantly lower than those in the non-standardized group There was statistical significance (all P <0.05). The fasting blood glucose, glycosylated hemoglobin and oral glucose tolerance 2h blood glucose level in the normalized treatment group were significantly lower than those in the non-standardized treatment group (P <0.05) at 1 week postpartum and 3 months postpartum. The incidence of impaired glucose tolerance in the standardized treatment group was significantly Lower than the non-standardized treatment group, the difference was statistically significant (P <0.05). Standardized treatment during pregnancy, postpartum breastfeeding and postpartum diet interventions contribute to the normal return of abnormal glucose metabolism; hyperlipidemia is not conducive to the outcome of abnormal glucose metabolism. Conclusion The standardized treatment during pregnancy in GDM patients can significantly reduce the perinatal maternal and infant complications, is conducive to improving pregnancy outcomes, control postpartum blood glucose and glucose metabolism abnormalities.