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目的探讨不同时期应用胰岛素治疗对妊娠合并糖尿病患者妊娠结局的影响。方法选取2010年12月—2014年12月攀枝花市仁和区人民医院收治的妊娠合并糖尿病患者88例,根据孕周分为研究组(孕周≤32周)与对照组(孕周>32周),各44例。两组患者均采用胰岛素治疗,研究组患者孕周第29周时使用,对照组患者孕周第34周时使用。观察两组患者治疗前后空腹血糖、餐后2h血糖及妊娠结局。结果治疗前后两组患者空腹血糖、餐后2h血糖比较,差异无统计学意义(P>0.05);两组患者治疗后空腹血糖、餐后2h血糖低于治疗前,差异有统计学意义(P<0.05)。两组患者剖宫产、胎儿窘迫发生率比较,差异无统计学意义(P>0.05);研究组患者巨大儿、死胎发生率低于对照组,差异有统计学意义(P<0.05)。结论孕周≤32周妊娠合并糖尿病患者予以胰岛素治疗,可改善患者妊娠结局,降低巨大儿、死胎发生率。
Objective To investigate the effect of insulin treatment in different periods on pregnancy outcomes in patients with gestational diabetes mellitus. Methods Eighty-eight pregnant women with diabetes mellitus who were admitted to Renhe District People’s Hospital of Panzhihua City from December 2010 to December 2014 were divided into study group (gestational age ≤32 weeks) and control group (gestational age> 32 weeks) , 44 cases each. Both groups were treated with insulin. The study group was used at 29 weeks of gestation and the control group at week 34 of gestation. Fasting blood glucose, postprandial 2h glucose and pregnancy outcome were observed before and after treatment in both groups. Results There was no significant difference in fasting blood glucose and postprandial 2h blood glucose between the two groups before and after treatment (P> 0.05). Fasting blood glucose and postprandial blood glucose 2h after treatment were lower in both groups (P <0.05). There was no significant difference in incidence of cesarean section and fetal distress between the two groups (P> 0.05). The incidence of macrosomia and stillbirth in study group was lower than that in control group (P <0.05). Conclusion Pregnancy ≤32 weeks of pregnancy with diabetes in patients with insulin treatment, can improve the pregnancy outcome, reduce the incidence of macrosomia and stillbirth.