【摘要】 目的探讨医学营养治疗在妊娠期糖代谢异常治疗中的作用。方法2007年7—12月在广东省人民医院确诊为妊娠期糖代谢异常的单胎孕妇83例,按照其孕中期有无看营养门诊分为研究组40例和对照组43例,两组孕妇均由产科医师定期随诊,研究组孕妇同时有专业营养医师随访,并采用食物交换份法(FEL)联合食物血糖负荷法(GL)进行医学营养治疗,比较两组孕妇的孕期血糖、体质量和围生期结局。结果妊娠期糖代谢异常的发生率为5.76%(83/1440),其中妊娠糖尿病(GDM)发生率为2.43%(35/1440),妊娠糖耐量减低(GIGT)发生率为3.33%(48/1440)。治疗前两组孕妇的空腹血糖及餐后2 h血糖水平间差别均无统计学意义(P>0.05),治疗后两组孕妇的空腹血糖及餐后2 h血糖水平间差别均有统计学意义(P<0.05)。两组孕妇孕期体质量总增加量和每周体质量增加量间差别均有统计学意义(P<0.05)。两组新生儿出生体质量间差别无统计学意义(P>0.05)。研究组早产、巨大儿、胎儿窘迫的发生率分别为12.5%、2.5%和7.5%,低于对照组,但差别无统计学意义(P>0.05)。结论科学的营养治疗可改善妊娠期糖代谢异常者的餐后血糖,对其孕期体质量增加的管理有指导作用。更多还原

【Abstract】 Objective To investigate the effect of medical nutrition therapy(MNT) on the pregnancy women with abnormal glucose metabolism.Methods Totally 83 cases of single pregnancy women with abnormal glucose metabolism in Guangdong Provincial People′s Hospital from Jul.2007 to Dec 2007 were divided as trial group(n=40) and control group(n=43) according to whether they seek for nutritional consulting during their medial period of pregnancy.The pregnant women in both groups received periodical cares from obstetricians,and those in the trial group were given additional cares by professional dieticians and received MNT of food exchange list(FEL) plus glycemic load(GL).The blood sugar levels during the pregnant periods,weight gain in pregnancy,and final outcomes of the pregnancy women and infants between the two groups were compared.Results The incidence of abnormal glucose metabolism during the pregnant period was 5.76%(83/1440),of which that of gestational diabetes mellitus(GDM) was 2.43%(83/1440) and that of gestational impaired glucose tolerance(GIGT) was 3.33%(35/1440).There were no significant differences before treatment in fasting blood glucose(FBG) and 2-h postprandial blood glucose(PBG) between the two groups(P>0.05),however there were after treatment(P<0.05).Between the two groups,there were significant differences in the total amount and weekly amount of pregnant women′s weight gain(P<0.05),and so there was no significant difference in newborns′ body weight(P>0.05).The incidence of premature,macrosomia and fetal distress were 12.5%,2.5% and 7.5% respectively,lower than those in the control group,but with no statistical significance(P>0.05).Conclusion MNT may improve the postprandial blood glucose for pregnancy women with abnormal glucose metabolism,it is of a guiding role for the management of their weight gain.更多还原