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目的:探讨个体化医学营养治疗(MNT)对妊娠期糖尿病患者血糖、体重、妊娠结局的影响。方法:选取妇产科和内分泌科确诊的妊娠糖尿病患者60例,随机分为两组。对照组接受内分泌科传统饮食指导;观察组接受营养医师制定的个体化医学营养治疗方案,比较两组孕妇体重变化、妊娠结局、新生儿体重,以及治疗前后、分娩前血糖水平。结果:两组孕妇孕期体重增长比较差异有统计学意义(t=6.468,P=0.000),观察组体重增长更接近合理数值;两组新生儿出生体重比较差异有统计学意义(t=10.389,P=0.000),观察组新生儿体重更接近合理数值。观察组巨大儿发生率低于对照组(χ2=9.231,P=0.002),观察组剖宫产率低于对照组(χ2=5.455,P=0.02);治疗1周后观察组患者空腹血糖(FPG)正常率高于对照组(χ2=6.787,P=0.009);观察组患者餐后1 h血糖正常率高于对照组(χ2=11.380,P=0.001);观察组患者餐后2 h血糖正常率高于对照组(χ2=6.944,P=0.008),最后一次产检观察组患者空腹血糖(FPG)正常率高于对照组(χ2=13.303,P=0.000);观察组患者餐后1 h血糖正常率高于对照组(χ2=11.279,P=0.001);观察组患者餐后2 h血糖正常率高于对照组(χ2=11.279,P=0.001);分娩前两组Hb A1c比较差异有统计学意义(t=3.105,P=0.003);产后6~12周葡萄糖耐量试验(OGTT)2 h血糖正常转归率观察组大于对照组(χ2=5.934,P=0.015)。结论:MNT能提高妊娠期糖尿病(GDM)患者血糖达标率,能有效控制GDM患者体重增长及胎儿出生体重,能有效改善妊娠结局。本研究将探讨个体化医学营养治疗(MNT)对GDM患者及其胎儿的影响。
Objective: To investigate the effect of individualized medical nutrition therapy (MNT) on blood glucose, body weight and pregnancy outcome in patients with gestational diabetes mellitus. Methods: 60 cases of gestational diabetes diagnosed by obstetrics and gynecology and endocrinology were randomly divided into two groups. The control group received the endocrinology traditional dietary guidance. The observation group received individualized medical nutrition treatment plan formulated by nutritionist. The weight changes of pregnant women, pregnancy outcome, newborn weight and blood glucose level before and after treatment were compared between the two groups. Results: There was a significant difference in weight gain between the two groups during pregnancy (t = 6.468, P = 0.000). The body weight gain in the observation group was closer to a reasonable value. There was significant difference in birth weight between the two groups (t = 10.389, P = 0.000), the newborns in the observation group closer to a reasonable body weight. The incidence of macrosomia in the observation group was lower than that in the control group (χ2 = 9.231, P = 0.002). The cesarean section rate in the observation group was lower than that in the control group (χ2 = 5.455, P = 0.02) FPG) was higher than that of the control group (χ2 = 6.787, P = 0.009). The normal 1-h postprandial blood glucose level was higher in the observation group than in the control group (χ2 = 11.380, P = 0.001) (Χ2 = 6.944, P = 0.008). The normal rate of fasting plasma glucose (FPG) was higher in the last production examination group than in the control group (χ2 = 13.303, P = 0.000) The normal rate of blood glucose was higher than that of the control group (χ2 = 11.279, P = 0.001). The normal rate of 2 h postprandial blood glucose in observation group was higher than that of the control group (χ2 = 11.279, P = 0.001) Statistical significance (t = 3.105, P = 0.003). The normal rate of return of glucose in 2 h postnatal glucose tolerance test (OGTT) was higher in the observation group than in the control group (χ2 = 5.934, P = 0.015). Conclusion: MNT can improve the blood glucose compliance rate of patients with gestational diabetes mellitus (GDM), effectively control the weight gain and fetal birth weight of GDM patients, and can effectively improve the pregnancy outcome. This study examines the impact of personalized medical nutrition therapy (MNT) on GDM patients and their fetuses.