李远西+雷加萍

摘要：目的 探討择期剖宫产和阴道分娩方式对产妇及其分娩的足月新生儿早期血糖的影响。方法 选择 2016年3月～2016年10月正常妊娠孕妇及分娩的足月新生儿 200例，产妇年龄（20～35岁），孕周（37～42 w），孕期血糖正常，无妊娠合并症；新生儿出生体重（2500～4000 g），所有新生儿均无感染、胎粪吸入、新生儿窒息、无先天畸形及合并症，其中择期剖宫产组100例，阴道分娩组100例，测定分娩时产妇血糖及新生儿于出生后30 min内，未开奶前血糖值，进行回顾性分析。结果 择期剖宫产组产妇及新生儿低血糖发生率明显高于阴道分娩组，两组比较，差异有统计学意义（P<0.05）；阴道分娩组产妇及新生儿高血糖发生率明显高于择期剖宫产组，两组比较，差异有统计学意义（P<0.05）。结论 产妇在生产时，产妇的血糖对新生儿血糖是有影响的，足月新生儿存在生后早期发生低血糖的可能，择期剖宫产组产妇及新生儿低血糖发生率大于阴道分娩组，择期剖宫产产妇分娩前长期禁食对产妇及新生儿的血糖是有影响的；阴道分娩组产妇及新生儿高血糖发生率明显大于择期剖宫产组，阴道分娩产妇无节制大量摄入高糖食物对产妇及新生儿血糖也是有影响的。

关键词：分娩方式；足月新生儿；血糖

中图分类号：R722.1 文献标识码：A 文章编号：1006-1959（2017）14-0089-02

Effect of Delivery Mode on Early Blood Glucose in Full-term Neonates

LI Yuan-xi，LEI Jia-ping

（Department of Pediatrics，Second People's Hospital of Chengdu，Chengdu 610000，Sichuan，China）

Abstract：Objective To investigate the effect of blood glucose on maternal and neonatal early delivery of elective cesarean section and vaginal delivery.Methods 200 cases of full-term newborns in March 2016～2016 October delivery of pregnant women and normal pregnancy，maternal age （20 ～35），gestational age（37～42 w），normal blood glucose during pregnancy，no complications of pregnancy；neonatal birth weight（2500～4000 g），all the infants were no infection，meconium aspiration，neonatal asphyxia，congenital malformation and no complications，including elective cesarean section in 100 cases，vaginal delivery group 100 cases，determination of blood glucose and neonatal birth women born after 30 min，no milk before blood glucose values were analyzed retrospectively.Results Elective cesarean section and neonatal hypoglycemia was significantly higher than that in vaginal delivery group，the two groups，the difference was statistically significant（P<0.05）；vaginal delivery group of maternity and neonatal hyperglycemia the incidence rate was significantly higher than that of cesarean section group，the difference was statistically significant between the two groups（P<0.05）.Conclusion Maternal blood glucose has an effect on neonatal blood glucose，and there may be hypoglycemia in early stage of neonatal birth.The incidence of hypoglycemia in pregnant women and neonates is higher than that in vaginal delivery group，elective cesarean section maternal long-term fasting before delivery to maternal and neonatal blood glucose is influential；vaginal delivery group of maternal and neonatal hyperglycemia was significantly greater than the elective cesarean section，vaginal delivery of maternal unrestrained intake of high-sugar foods on maternal and neonatal blood glucose is also affected.

Key words：Mode of delivery；Full-term neonates；Blood sugar

近年来，在综合因素的影响下剖宫产率明显提高，选择性剖宫产术前禁食是为了防止术中、术后发生呕吐、误吸等麻醉及手术意外或并发症，禁食作为术前准备常规的意义勿庸置疑。然而孕期糖代谢有显著变化，饥饿对于孕妇比非孕妇更易引起血糖浓度的下降，而剖宫产产妇术中输入不含糖液维持静脉压已成为常规，若术前禁食时间长可进一步加速产妇的饥饿状态，使产妇及新生儿发生低血糖[1]。新生儿血糖与孕妇产时血糖关系密切。剖宫产术前产妇禁食时间较长，择期剖宫产术分娩新生儿低血糖发生率亦增高。新生儿低血糖是指新生儿血糖值低于正常新生儿的最低血糖值。许多疾病都会导致低血糖的发生，低血糖可使脑细胞失去基本的能量来源，脑代谢和生理活动无法进行，如不及时纠正会造成永久性脑损伤[2]。……