肖瑩
[摘要] 目的 探討了胰島素聯(lián)合飲食運動在妊娠期糖尿病控制血糖方面的臨床效果。 方法 方便選取2017年6月—2018年6月該院收治的妊娠期糖尿病患者87例,按照隨機數(shù)表法分為兩組,對照組43例,采取常規(guī)性孕期指導(dǎo),觀察組44例,應(yīng)用胰島素聯(lián)合飲食運動進行血糖控制,將兩組血糖控制效果進行對比。 結(jié)果 觀察組患者血糖(7.12±1.59)mmol/L、HOMA-IR(2.72±0.74)μU/mL均優(yōu)于對照組(9.21±1.28)mmol/L和(3.64±0.88)μU/mL,差異有統(tǒng)計學(xué)意義(t=6.744、2.282,P<0.05),觀察組破宮產(chǎn)10例、羊水過多2例、胎兒窘迫2例、早產(chǎn)1例、巨大兒2例、新生兒窒息3例、妊娠期血壓疾病3例少于對照組破宮產(chǎn)25例、羊水過多13例、胎兒窘迫10例、早產(chǎn)15例、巨大兒12例、新生兒窒息13例、妊娠期血壓疾病12例,差異有統(tǒng)計學(xué)意義(χ2=11.341、10.056、6.402、15.409、8.790、7.943、6.778,P<0.05)。結(jié)論 胰島素聯(lián)合飲食運動在妊娠期糖尿病控制血糖方面,能夠取得良好的應(yīng)用效果。
[關(guān)鍵詞] 胰島素;飲食運動;妊娠期;糖尿病;控制血糖
[中圖分類號] R5? ? ? ? ? [文獻標(biāo)識碼] A? ? ? ? ? [文章編號] 1674-0742(2019)06(b)-0088-03
[Abstract] Objective To investigate the clinical effect of insulin combined with diet exercise on the control of blood glucose in gestational diabetes. Methods Convenient select from June 2017 to June 2018, 87 patients with gestational diabetes mellitus admitted to our hospital were divided into two groups according to the random number table method, and 43 patients in the control group. The routine pregnancy guidance was used, and 44 patients in the observation group were treated with insulin combined diet exercise for blood glucose control, the two groups of blood glucose control effects were compared. Results The blood glucose (7.12±1.59) mmol/L and HOMA-IR (2.72±0.74) μU/mL were better in the observation group than in the control group (9.21±1.28) mmol/L and (3.64±0.88) μU/mL. Statistical significance (t=6.744, 2.282, P<0.05), observation group 10 cases of rupture, 2 cases of amniotic fluid, 2 cases of fetal distress, 1 case of premature delivery, 2 cases of giant babies, 3 cases of neonatal asphyxia, pregnancy 3 cases of blood pressure disease were less than 25 cases of control group, 13 cases of amniotic fluid, 10 cases of fetal distress, 10 cases of premature delivery, 12 cases of premature birth, 13 cases of neonatal asphyxia, 12 cases of neonatal asphyxia, 12 cases of gestational blood pressure disease, the difference was statistical significance (χ2=11.341, 10.056, 6.402, 15.409, 8.790, 7.943, 6.778, P<0.05). Conclusion Insulin combined with diet exercise can achieve good application results in the control of blood glucose in gestational diabetes.
[Key words] Insulin; Diet exercise; Pregnancy; Diabetes; Control of blood glucose
妊娠期糖尿病簡稱GDM多發(fā)于孕婦的妊娠期,臨床癥狀不明顯,在我國發(fā)病率在1.5%~4.3%之間[1]。近年來由于飲食結(jié)構(gòu)的變換,患病人數(shù)有所上升,因此需要采取綜合治療方法控制的血糖濃度。而胰島素聯(lián)合飲食運動能夠?qū)θ焉锲谔悄虿【哂辛己每刂菩Ч鸞2-3]。通過運動、飲食聯(lián)合胰島素用藥,能夠有效調(diào)節(jié)血糖水平,改善胰島β細胞功能,使患者的血糖水平得到有效控制。該文方便選取2017年6月—2018年6月該院收治的妊娠期糖尿病患者87例進行分組研究,報道如下。
綜上所述,在妊娠期糖尿病控制血糖方面采用胰島素聯(lián)合飲食運動的控制手段,能夠有效穩(wěn)定孕婦體內(nèi)的血糖水平,減少不良妊娠結(jié)局的發(fā)生的概率,值得臨床推廣。
[參考文獻]
[1]? Ares J, Martín-Nieto A, Díaz-Naya L, et al. Gestational Diabetes Mellitus (GDM): Relationship Between Higher Cutoff Values for 100?g Oral Glucose Tolerance Test (OGTT) and Insulin Requirement During Pregnancy[J]. Mate- rnal & Child Health Journal, 2017, 21(7):1-5.
[2]? 計靜, 韓蓁, 米陽,等. 地特胰島素聯(lián)合門冬胰島素治療妊娠合并糖尿病患者的安全性及有效性研究[J].中國糖尿病雜志, 2017, 25(4):325-329.
[3]? 辛嬋娟. 基于動態(tài)血糖監(jiān)測胰島素泵聯(lián)合飲食、運動干預(yù)治療妊娠期糖尿病的臨床研究[J].中國醫(yī)療器械信息, 2017, 23(16):133-134.
[4]? 段潤美.關(guān)于妊娠期糖尿病飲食及運動治療的體會[J]. 中國社區(qū)醫(yī)師, 2017, 15(12):168-169.
[5]? Kapaya H, May L, Jacques R, et al. Sensitivity of postnatal fasting plasma glucose in identifying impaired glucose tolerance in women with gestational diabetes - 25 Years' data[J]. Obstet Med, 2017, 10(3):125-131.
[6]? Lindsay KL, Brennan L, Kennelly MA, et al. Maternal metabolic response to dietary treatment for impaired glucose tolerance and gestational diabetes mellitus[J].Irish Journal of Medical Science, 2018, 12(14):1-8.
[7]? 劉小英, 劉紅梅, 譙艷,等. 家庭運動干預(yù)聯(lián)合飲食控制對妊娠期糖尿病患者脂肪因子及妊娠結(jié)局的影響[J].中國婦幼保健, 2017, 32(14):3114-3117.
[8]? Simeonovakrstevska S, Bogoev M, Bogoeva K, et al. Maternal and Neonatal Outcomes in Pregnant Women with Gestational Diabetes Mellitus Treated with Diet, Metformin or Insulin[J]. Open Access Macedonian Journal of Medical Sciences, 2018, 6(5):803-807.
[9]? 張曉平. 運動聯(lián)合飲食干預(yù)對妊娠期糖尿病患者胰島素抵抗、血清脂聯(lián)素和內(nèi)脂素水平的影響[J].中國婦幼保健, 2017, 32(9):1869-1871.
[10]? 黎普茜, 李栩萍. 動態(tài)血糖檢測聯(lián)合胰島素控制妊娠期糖尿病血糖水平的臨床療效[J].吉林醫(yī)學(xué), 2017, 38(7):1264-1266.
[11]? 蔡美云, 劉裕韓, 洪程銘,等. 運動療法對妊娠期糖尿病患者血糖及妊娠結(jié)局的影響研究[J]. 齊齊哈爾醫(yī)學(xué)院學(xué)報, 2017, 38(10):1169-1170.
[12]? Singh N, Madhu M, Vanamail P. Efficacy of metformin in improving glycaemic control & perinatal outcome in gestational diabetes mellitus: A non-randomized study[J]. Indian Journal of Medical Research, 2017, 145(5):623-628.
[13]? 馮英微, 呂振青. 飲食和運動干預(yù)對妊娠期糖尿病孕婦血糖調(diào)控的作用[J]. 罕少疾病雜志, 2017, 24(3):57-58.
(收稿日期:2019-03-16)