冯秀敏

[摘要] 目的 探讨非妊娠期糖尿病巨大儿的临床特征及相关因素分析。 方法 整群选择2012年6月—2014年6月在该院出生的非妊娠期糖尿病巨大儿和母亲270例，随机选择同期分娩的270例正常体重儿或母亲回顾性对照分析。 结果 非妊娠期糖尿病巨大儿平均胎龄、BPD、FL、AC、身长、体重分别为280.90 d、9.73 cm、7.41 cm、35.61 cm、51.55 cm 、4170 g，明显高于对照组的270 d、9.38 cm、7.09 cm、32.60 cm、48.20 cm、3580 g，巨大儿组男性180例，多于对照组的119例；巨大儿母亲的孕期体重增长17.86 kg，高于对照组的15.63 kg；巨大儿组产程进展及枕位异常100例、产后出血68例、剖宫产127例，而对照组分别为38例、22例及47例。 结论 非妊娠期糖尿病巨大儿以男性居多，其发生与母亲孕期体重增长、宫高、腹围因素有关，并导致母亲分娩过程中产程进展异常发生率、产后出血率、剖宫产率显著增加，积极预防非糖尿病巨大儿的发生是提高产科质量的重要措施。

[关键词] 巨大儿；非妊娠期糖尿病；宫高；腹围

[中图分类号] R587.1 [文献标识码] A [文章编号] 1674-0742（2015）05（b）-0043-02

Clinical Anlysis of Non-gestational Diabetes Macrosomia

FENG Xiu-min

Department of Gynecology and ObStetrics， Tieying Hospital of Fengtai District， Beijing， 100079 China

[Abstract] Objective In this paper，the clinical characteristics and related factors of non-gestational diabetes macrosomia was explored. Methods 270 cases of non-gestational diabetes macrosomia（or mother） born during June 2012 -June 2014 were compared with 270 cases with normal-birth-weight newborn randomly selected in the same period for the retrospective case-control study in our hospital. Results The average gestational age， BPD， FL， AC， body length， body weight were 280.90 days， 9.73 cm， 7.41 cm， 35.61 cm， 51.55 cm， 4170 grams， apparently higher than 270 days， 9.38 cm， 7.09 cm， 32.60 cm， 48.20 cm， 3580 grams of the control group respectively；there were 180 cases of male in macrosomia group， more than the 119 cases in the control group. The mother's pregnancy weight gain was 17.86 kilograms， which was more than 15.63 kilograms of the control group. There were 100 cases labor progress and pillow abnormalities ，68 cases postpartum hemorrhage ， 127 cases cesarean section in macrosomia group，while in the control group there were 38 cases， 22 cases and 47 cases respectively. Conclusion The male are in the majority in the non-gestational diabetes macrosomia， their incidences were related to their motherrs' weight gain， uterine height， and abdomen circumference， which led to the high rate of abnormal progress during the stages of labor， postpartum hemorrhage and ratio of cesarean section delivery significantly. So， positively prevent the happening of the diabetic macrosomia is one of the important measures to improve the quality of obstetrics.

[Key words] Macrosomia；Non-gestational diabetes；Uterine fundal height；Abdominal circumference

随着家庭对孕产妇的重视、生活水平的改善及生活方式的改变，巨大儿的发生率呈逐年上升的趋势，其中非糖尿病巨大儿所占比例增高。胎儿体重超过4000 g者称为巨大儿，巨大儿属于高危妊娠，对母亲可造成阴道分娩过程中产程延长、难产、软产道损伤、继发性宫缩乏力、产后出血、手术助产、剖宫产率增加；对胎儿可导致新生儿产伤如肩难产、锁骨骨折、臂丛神经损伤、颅内出血、新生儿窒息甚至死亡等[1]。因此，对其临产特征及发生的相关因素进行探讨具有重要意义。该研究采用病例对照方法对2012年6月—2014年6月在该院出生的非妊娠期糖尿病巨大儿270例及同期随机分娩的正常体重儿270例进行回顾性分析，现报道如下。……