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目的探讨妊娠期糖尿病孕妇血糖监测与围产结局的关系。方法选择2008年1月—2011年1月在浙江大学医学院附属妇产科医院产前检查的妊娠期糖尿病孕妇197例。所有孕妇采用饮食指导结合运动锻炼控制血糖水平,必要时加用胰岛素治疗。根据孕妇自我血糖监测的频率分为每天监测4次组共40例(A组),隔天监测4次组共88例(B组),每周1天监测4次组共69例(C组)。比较分析3组血糖监测方式的依从性差异以及孕产妇并发症发生率。结果 B组和C组监测方式的依从性明显高于A组,差异有统计学意义(P<0.01)。C组孕产妇发生子痫前期、新生儿窒息、羊水过多、早产、新生儿低血糖、巨大儿和剖宫产率均高于A组和B组。而A组和B组各围产期并发症发生率差异无统计学意义(P>0.05)。结论经饮食调整和运动控制血糖水平的孕妇,可以隔天监测血糖水平,既能孕妇经济和精神负担,又能降低围产期并发症。采用胰岛素控制血糖的患者仍要每天监测,减少母婴并发症发生。
Objective To investigate the relationship between blood glucose monitoring and perinatal outcome in pregnant women with gestational diabetes mellitus. Methods From January 2008 to January 2011, 197 pregnant women with gestational diabetes underwent prenatal examination at the Obstetrics and Gynecology Hospital of Zhejiang University Medical College. All pregnant women with diet guidance combined with exercise control blood sugar levels, if necessary, plus insulin therapy. According to the frequency of self-monitoring of blood glucose in pregnant women, there were 40 cases (group A), 4 times a day, 88 cases (group B), 4 times a day, and 69 cases ). Comparative analysis of three groups of blood glucose monitoring compliance differences and maternal complications. Results The compliance of monitoring methods in group B and group C was significantly higher than that in group A, the difference was statistically significant (P <0.01). Group C pregnant women with preeclampsia, neonatal asphyxia, polyhydramnios, premature birth, neonatal hypoglycemia, macrosomia and cesarean section rate were higher than the A and B group. There was no significant difference in the incidence of perinatal complications between group A and group B (P> 0.05). Conclusions Pregnant women whose dietary adjustments and exercise control their blood glucose levels can monitor their blood sugar levels the next day, both in terms of their economic and mental burdens, and in reducing perinatal complications. Patients with insulin control of blood glucose should still be monitored daily to reduce the incidence of maternal and child complications.