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目的观察实施动态血糖监测联合胰岛素泵双波疗法在妊娠糖尿病中的疗效研究。方法选取正常孕妇20例及妊娠糖尿病患者46例,将妊娠糖尿病患者分为胰岛素泵常规波治疗组和胰岛素泵双波治疗组,对所有入组孕妇实施动态血糖监测。对比3组平均血糖值、平均血糖漂移幅度、三餐后血糖漂移幅度、低血糖发生率、日内血糖波动最大幅度及妊娠结局。结果与常规波组相比,双波组平均血糖漂移幅度[(2.26±0.94)mmol/L vs(3.52±1.41)mmol/L]、三餐后血糖漂移幅度、日内血糖波动最大幅度[(4.24±0.40)mmol/L vs(6.56±1.32)mmol/L]及剖宫产的发生率(8.7%vs34.78%)显著降低(P<0.05,P<0.01)。结论同胰岛素泵常规波形治疗方案相比,胰岛素泵双波疗法在妊娠糖尿病患者血糖控制的稳定性方面更具优势,可以有效降低剖宫产率。
Objective To observe the effect of dynamic glucose monitoring combined with insulin pump dual wave therapy in gestational diabetes mellitus. Methods Twenty healthy pregnant women and 46 pregnant women with gestational diabetes were selected. Patients with gestational diabetes mellitus were divided into two groups: conventional wave therapy with insulin pump and double wave therapy with insulin pump. All the pregnant women underwent dynamic blood glucose monitoring. The mean blood glucose level, average blood glucose level, postprandial glycemic excursion, incidence of hypoglycemia, maximum intragastric blood glucose fluctuation and pregnancy outcome were compared between the three groups. Results Compared with the conventional wave group, the average blood glucose drift amplitude in the two wave groups [(2.26 ± 0.94) mmol / L vs (3.52 ± 1.41) mmol / L], the postprandial blood glucose excursion and the maximum intragastric blood glucose fluctuation [ ± 0.40) mmol / L vs (6.56 ± 1.32) mmol / L, and the incidence of cesarean section (8.7% vs34.78%, P <0.05, P <0.01). Conclusion Compared with conventional waveform therapy of insulin pump, dual pump therapy of insulin pump has more advantages in the stability of glycemic control in patients with gestational diabetes mellitus, which can effectively reduce the rate of cesarean section.