妊娠期糖尿病患者围术期精确泵注胰岛素控制血糖水平对新生儿血糖影响.docVIP

妊娠期糖尿病患者围术期精确泵注胰岛素控制血糖水平对新生儿血糖影响 　　[摘要]目的 探究妊娠期糖尿病患者围术期精确泵注胰岛素控制血糖水平对新生儿血糖的影响。方法 选择2015年1月～2017年1月我院收治的妊娠期糖尿病行剖宫产终止妊娠患者100例，按照数字表法分为实验组和对照组，每组50例。实验组术前1 h给予葡萄糖70～100 mg/h静脉滴注，当血糖≥5.6 mmol/L给予正规胰岛素血糖值×0.12 U/h，对照组术前给予林格液。比较两组产妇孕期血糖、术前血糖、新生儿血糖以及出生后1 h的血糖水平变化。结果 治疗后，实验组产妇孕期和新生儿生后及生后1 h的血糖水平指标显著优于对照组，差异有统计学意义（P0.05）；对照组新生儿低血糖发生率为20%，显著高于实验组的6%，差异有统计学意义（P0.05）。结论 妊娠期糖尿病产妇围术期给予葡萄糖并经胰岛素泵静脉注射治疗，能有效促进孕妇及新生儿的血糖水平维持在相对稳定状态，降低新生儿低血糖发生率，保证新生儿健康。 　　[关键词]胰岛素泵；妊娠期糖尿病；围术期；新生儿血糖 　　[中图分类号] R714 [文献标识码] A [文章编号] 1674-4721（2017）12（b）-0068-03 　　[Abstract]Objective To investigate the effect of precise insulin infusion during perioperative period of patients with gestational diabetes mellitus on blood glucose level in neonates.Methods Altogether 100 patients with gestational diabetes mellitus who underwent termination of pregnancy by cesarean section in our hospital from January 2015 to January 2017 were selected and divided into the experiment group and the control group，with 50 cases in each group.The experiment group was given intravenous drip of glucose at 70-100 mg/h 1 h before surgery；when patients′ blood sugar was more than or equal to 5.6 mmol/L，the experiment group was given regular insulin （glucose value×0.12 U/h）；the control group was given Ringer′s solution preoperatively.The changes in maternal blood glucose level，preoperative blood glucose level， neonatal blood glucose level and blood glucose level 1 h after birth were compared between the two groups.Results The maternal blood glucose index，neonatal blood glucose index and neonatal blood glucose index 1 h after birth of experiment group were better than those of control group，with statistically significant difference （P0.05）；the incidence rate of neonatal hypoglycemia of control group was 20%，which was significantly higher than that of experiment group （6%），with statistically significant difference （P0.05）.Conclusion Treatment with glucose and intravenous insulin pump infusion in pregnant women with gestational diabetes