摘要
目的探讨改变进餐顺序对妊娠期糖尿病患者血糖及妊娠结局的影响。方法选取2016年1至6月在西安交通大学第一附属医院产科门诊确诊的妊娠期糖尿病(GDM)患者210例,随机分为干预组、非干预组各105例,干预组在医学营养治疗(MNT)基础上联合进餐顺序的调整,非干预组仅给予MNT。在同一时期,于该院产科门诊随机抽取正常孕妇105例作为正常对照组,探讨改变进餐顺序对GDM患者血糖及妊娠结局的影响。结果通过MNT的治疗措施后,三组妊娠期并发症和新生儿并发症比较均无显著差异(χ2值分别为1.846、1.803、0.743、0.390、1.630、1.151、0.985、5.464、1.846、2.654、1.824、1.369,均P>0.05)。在对干预组调整进餐顺序后,干预组的空腹血糖、餐后2h血糖以及糖化血红蛋白情况均优于非干预组,具有显著差异(t值分别为3.987、4.011、4.024,均P<0.05)。另外,在对妊娠期并发症和新生儿并发症的调查中发现,干预组的妊娠期高血压(1.9%)、胎儿窘迫(1.9%)、羊水过多(1.9%)、胎膜早破(14.3%)、剖宫产(36.2%)、早产(1.9%)发生比例均低于对照组(3.8%、4.8%、3.8%、21.0%、42.9%、3.8%),但差异均无统计学意义(χ2值分别为0.686、1.330、0.686、1.608、0.976、0.686,均P>0.05);干预组的巨大儿(0.0%)、足月低体重儿(1.0%)、新生儿低血糖(0.0%)、新生儿呼吸窘迫综合征(NRDS)(0.0%)、新生儿住院(2.9%)发生率均低于对照组(3.8%、1.9%、1.9%、1.0%、4.8%),但差异均无统计学意义(χ2值分别为4.078、0.338、2.019、1.005、0.520,P>0.05)。结论 MNT联合改变患者进餐顺序的治疗措施,对于GDM患者血糖控制,以及降低母儿并发症均具有正向的积极作用。
Objective To study the effect of changing dietary order on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus gestational diabetes mellitus （GDM）. Methods Totally 210 patients with GDM diagnosed in obstetrics outpatient department in First Affiliated Hospital of Xi＇an Jiaotong University from January to June 2016 were selected and randomly divided into intervention group and nonintervention group with 105 cases in each group. Patients in the intervention group were treated with adjusted dietary order on basis of medical nutrition therapy （MNT） and patients in the non-intervention group only received MNT. During the same period, 105 healthy pregnant women were randomly selected as control group from obstetrical outpatient department in the First Affiliated Hospital of Xi＇an Jiaotong University. Effects of changing dietary order on blood glucose and pregnancy outcomes of patients with GDM were investigated. Results After treatment of MNT, differences in pregnancy and neonatal complications in three groups were not significant （χ2 value was1.846, 1.803, 0.743, 0.390, 1.630, 1.151, 0.985, 5.464,1.846,2.654, 1.824 and 1.369 respectively, all P〈0.05）. Fasting blood glucose, blood glucose 2h after meal and glycosylated hemoglobin in the intervention group after changing dietary order were all better than those in the non-intervention group, and the differences were statistically significant （t value was 3.987, 4.011 and 4.024 respectively, all P 〉0.05）. What＇ s more, survey on pregnancy and neonatal complications found that incidences of gestational hypertension （1.9%）, fetal distress （1.9%）, hydramnios （1.9%）, premature rupture of membranes （14.3%）, cesarean section （36.2%）, premature birth （1.9%） in intervention group were lower than those in control group （3.80/00, 4.8%, 3.8%, 21.0%, 42.9%, 3.8%）, but differences had no significance （χ2 value was 0.686, 1.330, 0.686, 1.608, 0.976 and 0.686, respectively, all P〉0.05）. Incide
作者
廖侠
宋戈
鲜瑶
王恺
靳菊英
李卫敏
LIAO Xia;SONG Ge;XIAN Yao;WANG Kai;JIN Ju ying;LI Wei-min(Department of Nutrition, First Affiliated Hospital of Xi ＇an Jiaotong University, Shaanxi Xi ＇an 710061, China;Department of Nutrition, Hebei People＇s Hospital, Hebei Shijiazhuang 050051, China)
出处
《中国妇幼健康研究》
2018年第5期569-573,共5页
Chinese Journal of Woman and Child Health Research
基金
陕西省社会发展科技攻关资助项目(编号:2016SF-319)
关键词
妊娠期糖尿病
营养治疗
进餐顺序
妊娠结局
gestational diabetes mellitus （GDM）
nutritional therapy
dietary order
pregnancy outcomes
