基础—餐时胰岛素治疗糖尿病合并妊娠临床观察及其对妊娠结局的影响(1)
【摘要】 目的：糖尿病合并妊娠者临床行基础-餐时胰岛素治疗，观察其降糖效果、孕妇妊娠结局以及新生儿情况。方法：选取本院住院部收治的36例糖尿病合并妊娠患者为研究对象，按照随机数字表法分为两组，其中对比组18例，观察组18例，比较孕妇血糖指标变化情况，记录孕妇血糖达标用时、胰岛素用量，统计孕妇妊娠结局、低血糖以及新生儿情况。结果：观察组孕妇不良妊娠结局、新生儿不良情况均较对比组少(P<0.05)；入院时两组血糖指标比较差异均无统计学意义(P>0.05)，胰岛素治疗后3个月空腹血糖、餐后2 h血糖以及糖化血红蛋白水平观察组均明显低于对比组(P<0.05)；对比组低血糖发生率为27.8%，高于观察组的5.6%(P<0.05)；观察组血糖达标用时、胰岛素使用量均较对比组少(P<0.05)。结论：糖尿病合并妊娠患者使用基础-餐时胰岛素治疗能有效控制孕妇血糖，降低低血糖的发生率，减少不良妊娠结局的发生。
【关键词】 基础-餐时胰岛素； 糖尿病合并妊娠； 妊娠结局
【Abstract】 Objective：To observe the clinical effect of basal-prandial Insulin in pregnant patients complicated with diabetes mellitus and its impact in the pregnancy outcome and neonatal complications.Method：A total of 36 pregnant patients complicated with diabetes mellitus in our hospital were selected.The subjects were randomly divided into the control group and the observation group，18 cases in each group.The blood glucose was recorded，the time of achieving the standard blood glucose，dose of Insulin as well as the pregnancy outcome，incidence rate of hypoglycemia and neonatal complications of two groups were observed.Result：The incidence rate of adverse pregnancy outcomes and neonatal complications of the observation group were lower than those of the control group(P<0.05).Upon admission to hospital，the blood glucose of two groups were not significantly different(P>0.05).After 3 months of treatment，the fasting blood glucose，2 h postprandial blood glucose and glycosylated hemoglobin of the observation group were significantly lower than those of the control group(P<0.05).The incidence rate of hypoglycemia of the control group(27.8%) was significantly higher than that of the observation group(5.6%)(P<0.05).The time of achieving the standard blood glucose，dose of insulin of the observation group were better than those of the control group(P<0.05).Conclusion：For pregnant patients complicated with diabetes mellitus，basal-prandial Insulin can effectively control the blood glucose，reduce the incidence rate of hypoglycemia and adverse pregnancy outcomes.
【Key words】 Basal-prandial Insulin； Pregnant patients complicated with diabetes mellitus； Pregnancy outcomes
First-author’s address：Nanxiong People’s Hospital，Nanxiong 512400，China
doi：10.3969/j.issn.1674-4985.2017.29.009
糖尿病合并妊娠包括妊娠期糖尿病(GDM)和孕前糖尿病(PGDM)，其中GDM發病率约占糖尿病合并妊娠的80%～90%，但只有不到5%孕妇需要使用胰岛素治疗才能控制血糖，而PGDM患者在孕前已确诊或在妊娠期首次被诊断，故需要使用胰岛素控制血糖[1-2]。胰岛素是临床糖尿病合并妊娠治疗药物首选，但不同胰岛素以及不同给药方式，临床降糖效果会有差异，有学者提出患者三餐前及睡前用药，不仅有良好降糖效果，同时血糖波动稳定，不良妊娠结局发生少[3-4]。本文观察基础-餐时胰岛素治疗方案应用于PGDM患者的效果，现报道如下。, http://www.100md.com(陈园胜 陈友方 宋涛)
【关键词】 基础-餐时胰岛素； 糖尿病合并妊娠； 妊娠结局
【Abstract】 Objective：To observe the clinical effect of basal-prandial Insulin in pregnant patients complicated with diabetes mellitus and its impact in the pregnancy outcome and neonatal complications.Method：A total of 36 pregnant patients complicated with diabetes mellitus in our hospital were selected.The subjects were randomly divided into the control group and the observation group，18 cases in each group.The blood glucose was recorded，the time of achieving the standard blood glucose，dose of Insulin as well as the pregnancy outcome，incidence rate of hypoglycemia and neonatal complications of two groups were observed.Result：The incidence rate of adverse pregnancy outcomes and neonatal complications of the observation group were lower than those of the control group(P<0.05).Upon admission to hospital，the blood glucose of two groups were not significantly different(P>0.05).After 3 months of treatment，the fasting blood glucose，2 h postprandial blood glucose and glycosylated hemoglobin of the observation group were significantly lower than those of the control group(P<0.05).The incidence rate of hypoglycemia of the control group(27.8%) was significantly higher than that of the observation group(5.6%)(P<0.05).The time of achieving the standard blood glucose，dose of insulin of the observation group were better than those of the control group(P<0.05).Conclusion：For pregnant patients complicated with diabetes mellitus，basal-prandial Insulin can effectively control the blood glucose，reduce the incidence rate of hypoglycemia and adverse pregnancy outcomes.
【Key words】 Basal-prandial Insulin； Pregnant patients complicated with diabetes mellitus； Pregnancy outcomes
First-author’s address：Nanxiong People’s Hospital，Nanxiong 512400，China
doi：10.3969/j.issn.1674-4985.2017.29.009
糖尿病合并妊娠包括妊娠期糖尿病(GDM)和孕前糖尿病(PGDM)，其中GDM發病率约占糖尿病合并妊娠的80%～90%，但只有不到5%孕妇需要使用胰岛素治疗才能控制血糖，而PGDM患者在孕前已确诊或在妊娠期首次被诊断，故需要使用胰岛素控制血糖[1-2]。胰岛素是临床糖尿病合并妊娠治疗药物首选，但不同胰岛素以及不同给药方式，临床降糖效果会有差异，有学者提出患者三餐前及睡前用药，不仅有良好降糖效果，同时血糖波动稳定，不良妊娠结局发生少[3-4]。本文观察基础-餐时胰岛素治疗方案应用于PGDM患者的效果，现报道如下。, http://www.100md.com(陈园胜 陈友方 宋涛)