孕期系統化管理對妊娠期糖尿病妊娠結局影響研究

張虹　蔣軍　李長雨　易嬌　李佳

[摘要] 目的 探討孕期系統化管理對妊娠期糖尿病（GDM）孕婦妊娠結局的影響。 方法 方便選取2018年8月—2019年2月在該院規律產檢至分娩的110例GDM孕婦作為研究對象，將接受孕期系統化管理、血糖控制滿意的68例孕婦納入觀察組，將未接受系統化管理、血糖控制不滿意的42例孕婦納入對照組，對比兩組分娩方式、妊娠并發癥發生情況和新生兒結局。 結果 觀察組剖宮產率為36.76%，顯著低于對照組的52.38%（χ2=2.587，P<0.05）;觀察組妊娠期高血壓、早產、羊水過多和產后出血發生率分別為2.94%、1.47%、2.94%、4.41% ，均顯著低于對照組的14.29%、14.29%、16.67%、19.05%（χ2=4.955、7.156、6.511、6.179，P<0.05），兩組胎膜早破發生率相當（χ2=1.321，P>0.05）;觀察組巨大兒、紅細胞增多癥、新生兒低血糖和新生兒窒發生率發生率分別為1.47%、0.00、1.47%、0、0.00%，顯著低于對照組的23.81%、9.52%、11.90%、14.29%（χ2=14.396、6.721、8.481、10.275，P<0.05）。 結論 孕期系統化管理在GDM孕婦中的應用，可顯著降低剖宮產率，減少妊娠期并發癥，改善新生兒結局。

[關鍵詞] 孕期系統化管理;妊娠期并發癥;妊娠期糖尿病;妊娠結局

[中圖分類號] R5? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）07（b）-0063-03

Study on the Effect of Systematic Management during Pregnancy on Pregnancy Outcome of Gestational Diabetes

ZHANG Hong， JIANG Jun， LI Chang-yu， YI Jiao， LI Jia

Department of Obstetrics and Gynecology， Linquan Branch， Anhui Maternal and Child Health Hospital， Linquan， Anhui Province， 236400 China

[Abstract] Objective To investigate the effect of systematic management during pregnancy on pregnancy outcomes in pregnant women with gestational diabetes mellitus （GDM）. Methods A total of 110 pregnant women with GDM who were routinely examined and delivered to our hospital from August 2018 to February 2019 in our hospital were enrolled. 68 pregnant women who were systematically managed during pregnancy and satisfied with glycemic control were included in the observation group. Forty-two pregnant women who were systematically managed and unsatisfied with glycemic control were included in the control group， comparing the two groups of delivery methods， pregnancy complications and neonatal outcomes. Results The cesarean section rate of the observation group was 36.76%， which was significantly lower than that of the control group 52.38% （χ2=2.587， P<0.05）. The incidence of hypertension， premature delivery， polyhydramnios and postpartum hemorrhage in the observation group was 2.94%， 1.47%， 2.94%， and 4.41% were significantly lower than 14.29%， 14.29%， 16.67%， and 19.05% of the control group （χ2=4.955， 7.156， 6.511， 6.179， P<0.05）. The incidence of breakage was comparable （χ2=1.321， P>0.05）; the incidence of macrosomia， polycythemia， neonatal hypoglycemia and neonatal spasticity in the observation group were 1.47%， 0.00%， 1.47%， 0， 0.00%， respectively， lower than that of the control group of 23.81%， 9.52%， 11.90%， and 14.29% lower than the control group （χ2=14.396， 6.721， 8.481， 10.275， P<0.05）. Conclusion The systematic management of pregnancy in pregnant women with GDM can significantly reduce the rate of cesarean section， reduce complications during pregnancy， and improve neonatal outcomes.