医学营养治疗对妊娠期糖尿病围生期结局的影响

[摘要] 目的 探讨医学营养治疗对妊娠期糖尿病围生期结局的影响。 方法 选择2011年1～12月期间在本院产前诊断为妊娠期糖尿病（GDM）、在产科营养门诊接受医学营养治疗的孕妇88例（研究组），在进行总热量控制的基础上，使用食物交换法结合食物升糖指数的方法进行饮食指导，经上述处理血糖控制不理想者配合胰岛素治疗。把同期未接受该方法而采用传统营养治疗的GDM孕妇197例作为对照（对照组），比较两组围生儿结局及孕产妇分娩结局。 结果 研究组的围生儿结局中巨大儿、胎儿窘迫、新生儿窒息发生率明显低于对照组，两组比较差异有统计学意义（P ﹤ 0.05）；在孕产妇分娩结局中妊娠高血压综合征、贫血、胎膜早破发生率研究组均明显低于对照组(均P ＜ 0.05)，两组剖宫产率比较研究组低于对照组，两组比较差异有统计学意义（P ＜ 0.05）。 结论 对EDM进行科学合理的营养治疗能降低孕产期母婴并发症发生，改善围生期结局。

[关键词] 营养治疗；妊娠期糖尿病；围生期

[中图分类号] R714.25 [文献标识码] A [文章编号] 1673-7210（2012）07（c）-0049-03

Effect of Medical nutrition therapy on perinatal outcome of gestational diabetes

FAN Yanlan1 KANG Zhaohai2 WU Shiyuan2 YUAN Jinjin2 XIONG Jing2 ZHENG Jie2

1.The 3rd People′s Hospital of Yueyang City, Hu′nan Province, Yueyang 414000, China; 2.Maternity and Child Health Hospital in Yueyang City, Hu′nan Province, Yueyang 414000, China

[Abstract] Objective To explore the impact of medical nutrition therapy for gestational diabetes perinatal outcome. Methods 88 cases of pregnant women, diagnosed with gestational diabetes mellitus (GDM) in the hospital antenatal clinics and obstetric nutrition clinic from January 2011 to December 2011, were selected as the study group and received medical nutrition therapy. The treatment was carried out by controlling the total calories, while guiding the diet with food exchange and food glycemic index. Patients, whose blood glucose controls were still not satisfactory after the above treatment, received the insulin therapy. Other 197 cases of gestational diabetes pregnant women chosen as the control group were received the traditional nutritional therap. Comparisons were made between the two groups in terms of the perinatal outcomes and the maternal birth outcomes. Results The incidence rates of perinatal outcomes in the study group, including the great children, fetal distress, neonatal asphyxia, were significantly lower than in the control group. The differences of the rates in those two groups were all statistically significant (all P ＜ 0.05). The incidence rates of maternal birth outcomes in study group, including pregnancy hypertension, anemia, premature rupture of membranes were all significantly lower than in control group(all P ＜ 0.05). The cesarean section rate of the control group was higher than it of the study group. The difference of the rate in the two groups was statistically significant(P ＜ 0.05). Conclusion A scientific and rational nutrition therapy to patients with gestational diabetes can reduce the maternal and fetal complications of pregnancy and childbirth, and improve the perinatal outcomes.