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目的探索胰岛素泵持续皮下注射治疗妊娠期糖尿病对新生儿的作用。方法 40例妊娠期糖尿病患者,随机分成对照组和观察组,各20例。对照组患者采用胰岛素多次持续注射方法治疗,观察组患者采用胰岛素泵持续皮下注射治疗,比较两组患者的血糖值、新生儿状况。结果治疗前,观察组患者的空腹血糖和餐后2 h血糖分别为(8.26±0.82)、(10.21±1.05)mmol/L,对照组患者分别为(8.35±0.74)、(10.14±1.09)mmol/L;治疗5 d时,观察组患者的空腹血糖和餐后2 h血糖分别为(5.27±0.35)、(7.26±0.45)mmol/L,对照组患者分别为(6.10±0.46)、(8.07±0.42)mmol/L;治疗前两组空腹血糖和餐后2 h血糖比较差异无统计学意义(P>0.05);治疗5 d时观察组患者的空腹血糖和餐后2 h血糖低于对照组,差异有统计学意义(P<0.05)。观察组患者的血糖达标时间、胰岛素用量分别为(3.48±0.45)d、(30.1±2.3)U,优于对照组的(8.18±0.76)d、(45.7±4.5)U,差异有统计学意义(P<0.05)。观察组新生儿中出现2例早产儿,1例巨大儿,并发症发生率为15.0%;对照组新生儿中出现3例早产儿,3例巨大儿,3例新生儿窒息,2例高胆红素血症,并发症发生率为55.0%;观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论胰岛素泵持续皮下注射治疗妊娠期糖尿病有助于缩短治疗疗程,促进患者血糖水平降低,并且能最大限度减轻对新生儿的影响,保障新生儿健康。同时,胰岛素泵用法简单,患者的痛苦少,更容易接受,值得推广应用。
Objective To explore the effect of continuous subcutaneous injection of insulin pump on neonatal in gestational diabetes mellitus. Methods Forty patients with gestational diabetes mellitus were randomly divided into control group and observation group, with 20 cases in each group. Patients in the control group were treated with continuous injection of insulin for many times. Patients in the observation group were treated by continuous subcutaneous injection of insulin pump. The blood glucose level and neonatal status were compared between the two groups. Results Before treatment, fasting blood glucose and postprandial blood glucose at 2 h were (8.26 ± 0.82) and (10.21 ± 1.05) mmol / L respectively in the observation group and (8.35 ± 0.74) and (10.14 ± 1.09) mmol / L, the fasting blood glucose and postprandial 2h blood glucose were (5.27 ± 0.35) and (7.26 ± 0.45) mmol / L respectively in the observation group and (6.10 ± 0.46) and (8.07 ± 0.42) mmol / L. There was no significant difference in fasting blood glucose and 2-hour postprandial blood glucose between the two groups before treatment (P> 0.05); on the 5th day after treatment, fasting blood glucose and postprandial blood glucose Group, the difference was statistically significant (P <0.05). The observed time of blood glucose in the observation group was (3.48 ± 0.45) d, (30.1 ± 2.3) U, which was significantly higher than that in the control group (8.18 ± 0.76) d and (45.7 ± 4.5) U, respectively, with significant difference (P <0.05). In the observation group, there were 2 premature children and 1 giant child in the newborn infants, the complication rate was 15.0%. In the control group, 3 premature infants, 3 giant children, 3 neonates with asphyxia, 2 hypercholesterolemia The incidence of complications was 55.0%. The complication rate in observation group was lower than that in control group (P <0.05). Conclusion Continuous subcutaneous injections of insulin pump in the treatment of gestational diabetes mellitus help to shorten the course of treatment, promote the reduction of blood glucose level, minimize the impact on the newborn and protect the health of the newborn. At the same time, insulin pump usage is simple, less painful patients, more acceptable, it is worth promoting.