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目的探讨妊娠期糖尿病(GDM)的规范化管理对妊娠结局的影响。方法选择我院采用旧标准漏诊GDM而采用新标准确诊的GDM孕妇共200例,随机分入研究组1(GDM管理组)和研究组2(GDM不管理组),每组各100例。对研究组1给予医学营养、运动和药物治疗,进行规范化管理;选取同期120例正常妊娠孕妇作为对照组。观察GDM患者治疗前后血糖水平[空腹血糖(FPG)、餐后2h血糖(2hPG)、餐后最高血糖)]变化情况,同时观察和比较3组孕产妇并发症(妊高症、羊水过多、胎膜早破、产后出血)、分娩方式(阴道分娩、剖宫产)、围生儿结局(早产、巨大儿、新生儿窒息、新生儿呼吸窘迫综合征)。结果与治疗前相比,GDM患者治疗后FPG、2hPG、餐后最高血糖水平均显著降低(P<0.05);与对照组相比,研究组1患者在并发症、阴道分娩率、剖宫产率,以及围生儿结局等方面,差异均无统计学意义(P>0.05),而研究组2患者与对照组相比各妊娠结局发生率显著不同。结论对于GDM患者进行规范化管理能够达到正常妊娠结局。
Objective To investigate the effect of standardized management of gestational diabetes mellitus (GDM) on pregnancy outcome. Methods A total of 200 pregnant women with GDM who missed the diagnosis of GDM using the new standard and who were diagnosed with the new criteria were randomly divided into study group 1 (GDM management group) and study group 2 (GDM non-management group), 100 cases in each group. The study group 1 was given medical nutrition, exercise and drug treatment, standardized management; select the same period 120 cases of normal pregnant women as a control group. The changes of blood glucose level (fasting blood glucose (FPG), 2h postprandial blood glucose (2hPG) and postprandial hyperglycemia) of GDM patients were observed before and after treatment. The complications of maternal complications such as pregnancy-induced hypertension, polyhydramnios, Premature rupture of membranes, postpartum hemorrhage), mode of delivery (vaginal delivery, cesarean section), perinatal outcome (preterm birth, macrosomia, neonatal asphyxia, neonatal respiratory distress syndrome). Results Compared with those before treatment, FPG, 2hPG and the highest postprandial blood glucose level in GDM patients were significantly decreased (P <0.05). Compared with the control group, the incidence of complications, vaginal delivery rate, cesarean section Rate, and perinatal outcome, the difference was not statistically significant (P> 0.05), while the study group 2 patients compared with the control group, the incidence of pregnancy outcomes were significantly different. Conclusion The standardized management of GDM patients can achieve normal pregnancy outcomes.