目的 探讨动态血糖监测指导个体化营养与运动联合治疗妊娠期糖尿病的效果,为妊娠期糖尿病的疗效提供评价系统.方法 选取我院收治的96例妊娠期糖尿病孕妇,根据随机数字表法将孕妇平均分为观察组和对照组,每组48例.对照组孕妇给予常规妊娠糖尿病营养指导和适量运动,观察组孕妇根据血糖水平给予个体化营养与运动的联合治疗,比较2组孕妇治疗前、后血糖和血脂水平,并观察孕妇和新生儿出生体质量和妊娠结局.结果 治疗前2组妊娠期糖尿病孕妇生化指标、空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA1C)、三酰甘油(TG)和总胆固醇(TC)比较差异无统计学差异(P>0.05).经联合治疗后观察组妊娠期糖尿病孕妇生化指标(FBG、2 hPBG、HbA1C、TG和TC)显著低于治疗后对照组,差异存在统计学意义(P<0.05).联合治疗后观察组妊娠期糖尿病孕妇孕期总增重、每周增重、孕期体质量指数(BMI)增加和每周BMI增加以及新生儿出生体质量均明显低于治疗后对照组,同时观察组孕妇子痫前期、早产、羊水过多、巨大儿、剖宫产和产后出血比例均明显低于对照组,差异存在统计学意义(P<0.05).结论 动态血糖监测指导的个体化营养与运动的联合治疗能够降低妊娠期糖尿病孕妇血糖、血脂水平,改善孕妇和胎儿体质量,降低不良妊娠结局的产生,为妊娠糖尿病的综合治疗提供参考.%Objective To investigate the effects of individualized nutrition support guided by continuous blood glucose moni -toring combined with exercise therapy on gestational diabetes mellitus,so as to provide a possible evaluation system for gestational dia-betes mellitus treatment.Methods A total of 96 pregnant women with diabetes mellitus admitted into the hospital were enrolled for the study and were randomly divided into the observation group and the control group,each consisting of 48 subjects.The pregnant women in the control group received routine nutritional guidance and had proper exercise as instructed,while those in the observation group had individualized nutrition support combined with proper exercise, in accordance with the level of blood sugar.Then, blood glucose and blood lipid levels before and after treatment were detected and compared between the subjects of the 2 groups, and infant body weight and pregnancy outcome were closely observed and recorded.Results Before treatment,there were no statistical differences in the lev-els of fasting blood glucose(FBG),blood glucose 2 hour after meal,glycosylated hemoglobin(HbA1C),glycerin trilaurate(TG)and total cholesterol(TC),when comparisons were made between the 2 groups(P>0.05).After treatment,the levels of the biochemical indexes mentioned above in the observation group were significantly lower than those of the control group, and statistical significance could be noted when comparisons were made between the 2 groups(P<0.05).After treatment,rates of total weight gain during preg-nancy,weekly gain weight,BMI increase during pregnancy,BMI increased per week and weekly BMI and neonatal weight of the obser -vation group were significantly lower than those of the control group(P<0.05).At the same time,after treatment,rates of preeclamp-sia,premature birth,excess amniotic fluid,huge infant,cesarean section and postpartum hemorrhage in the observation group,were all significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Individualized nutrition sup-port guided by continuous blood glucose monitoring combined with proper exercise could obviously decrease blood glucose and lipid lev -els in pregnant women with gestational diabetes mellitus,improve the weight of pregnant women and fetus,and reduce the occurrence of adverse pregnancy outcomes.It could provide evidences for comprehensive clinical treatment of gestational diabetes mellitus.
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