摘要
目的:观察医学膳食营养治疗对糖耐量异常(Impaired Glucose Tolerance,IGT)孕妇妊娠糖尿病(Gestational Diabetes Mellitus,GDM)发病率及母婴结局的影响。方法:选取148例IGT孕妇作为研究对象,依据随机数表法分为试验组和对照组各74例,试验组采用医学膳食营养治疗,对照组采用常规饮食运动指导。观察治疗前及孕37周时两组孕妇糖代谢指标[空腹血糖、餐后2小时血糖、糖化血红蛋白]和营养学指标[血清总蛋白、白蛋白变化,比较两组孕妇妊娠结局和新生儿结局差异。结果:孕37周时,试验组患者空腹血糖、餐后2小时血糖和糖化血红蛋白水平均较治疗前显著降低,且明显低于同一时间对照组(均P<0.05),对照组患者空腹血糖、餐后2小时血糖和糖化血红蛋白水平均较治疗前无明显变化(均P>0.05);两组患者血清总蛋白和白蛋白水平均较治疗前显著升高,且试验组明显高于同一时间对照组(均P<0.05)。试验组孕妇剖宫产和GDM发生率均明显低于对照组(均P<0.05),两组孕妇产后出血(Postpartum Hemorrhage,PPH)、羊水异常和妊娠期高血压疾病(Pregnancy Hypertension Disease,PHD)发生率均无明显差异(均P>0.05)。试验组新生儿出生体质量和巨大儿例数均明显低于对照组(均P<0.05),两组新生儿胎儿窘迫、黄疸和大于胎龄儿(Large for Gestational Age,LGA)的发生率均无明显差异(均P>0.05)。结论:医学膳食营养治疗IGT孕妇可明显改善其孕期糖代谢功能,利于增加营养并降低GDM发病率,对改善母婴结局有一定优势,值得临床应用。
Objective:To observe the effect of medical dietary nutrition therapy on the incidence of gestational diabetes mellitus and maternal and infant outcomes in pregnant women with impaired glucose tolerance.Methods:148 cases of IGT pregnant women admitted to our hospital were selected as the research object,and were divided into the experimental group and the control group according to random number table method,74 cases for each.The experimental group was treated with medical dietary nutrition,and the control group was guided by conventional dietary exercise.Results:At 37 weeks of pregnancy,the levels of GLU,2 h PBG and HbA1c in the experimental group were significantly lower than before treatment,and were significantly lower than the control group(all P<0.05).The levels of GLU,2 h PBG and HbA1c in the control group showed no significant change compared with before treatment(all P>0.05).The levels of TP and ALB in the groups were significantly higher than before treatment,and those in the experimental group was significantly higher than those in the control group at the same time(both P<0.05).The incidence of cesarean section and GDM in pregnant women in the experimental group were significantly lower than the control group(both P<0.05).There was no significant difference in the incidence of PPH,amniotic fluid abnormalities and PHD between the groups(both P>0.05).The birth weight and the number of giant children in the experimental group were significantly lower than those in the control group(both P<0.05).There was no significant difference in the incidence of neonatal fetal distress,jaundice and LGA between the groups(all P>0.05).Conclusion:Medical dietary nutrition therapy on IGT pregnant women can significantly improve their glucose metabolism during pregnancy,which is beneficial to increase nutrition and reduce the incidence of GDM.It has certain advantages in improving maternal and infant outcomes,and is worthy of clinical application.
出处
《中医临床研究》
2021年第11期64-66,共3页
Clinical Journal Of Chinese Medicine
关键词
糖耐量异常
医学膳食营养治疗
妊娠糖尿病
妊娠结局
新生儿结局
IGT
Medical dietary nutrition therapy
Gestational diabetes mellitus
Pregnancy outcome
Neonatal outcome
