【摘要】 目的探讨妊娠期糖尿病(GDM)孕妇不同治疗方式对妊娠结局的影响。方法选择2017年4月—2018年6月我院产前检查发现的妊娠期糖尿病孕妇213例,分为生活方式干预组(A组)和胰岛素治疗组(B组),再根据血糖控制是否达标又分别分为血糖达标组与不达标组,选取同期1 113例血糖正常孕妇作为对照组,比较各组妊娠结局及母儿并发症的差异。结果 A组血糖控制不达标孕妇剖宫产、羊水过多、早产、巨大儿、胎儿生长受限、新生儿低血糖及新生儿转儿科的发生率均高于本组血糖达标孕妇及对照组,差异有统计学意义(P<0.05);B组血糖控制不达标孕妇剖宫产、羊水过多、胎膜早破、早产、巨大儿、新生儿低血糖及新生儿转儿科的发生率均高于本组血糖达标孕妇及对照组,差异有统计学意义(P<0.05)。结论不论GDM孕妇仅采用生活方式控制还是联合胰岛素治疗,当血糖控制不达标时,剖宫产、羊水过多、早产、巨大儿、新生儿低血糖及新生儿转儿科的发生率均增加,而孕期血糖控制达标可显著降低不良妊娠结局的发生率。更多还原

【Abstract】 Objective The curative effect ofdifferent treatment methods on pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM). Methods Total of 213 pregnant women with gestational diabetes mellitus have done the antenatal examination in our hospital from April 2017 to June 2018,and then divided into lifestyle intervention group(group A)and insulin treatment group(group B). Based on the result of blood glucosebelow or up to the standard value,the patients were divided into two groups:the standard group and the substandard group. In the same period,1113 pregnant women with normal glycemicwere selected as the control group,to comparethe differences of each group in pregnancy outcome and maternal and fetal complications. Results The incidences of cesarean section,oligohydramnios,pretermdelivery,macrosomia,fetalgrowth restriction,neonatalhypoglycemiaand neonatalconversion to pediatrics in GDM women with substandard glycemic control in group A were higher than those in group A with standard glycemic and control group. The results determine statistically significant(P<0.05). The incidences of cesarean section,oligohydramnios,premature rupture of membranes,premature delivery,macrosomia,neonatal hypoglycemia and neonatal conversion to pediatrics in GDM women with substandard glycemiccontrol in group B were higher than those in group B with standard glycemic and control group. The difference was statistically significant(P<0.05). Conclusion The clinic outcome illustrates that whether GDM pregnant women only took lifestyle intervention or combined insulin treatment,when glycemic control is substandard,the incidence of cesarean section,oligohydramnios,preterm delivery,macrosomia,neonatal hypoglycemia and neonatal conversion to pediatrics increased. Nevertheless,When the glycemic control up to standard during pregnancy,the incidence ofadverse outcome ofpregnancy can be significantly reduced.更多还原