综合治疗对多囊卵巢综合征合并糖尿病患者妊娠结局的影响研究

朱莉　刘桂艳　翟燕　王雪冬　关丹丹

[摘要] 目的 应用综合治疗方案治疗多囊卵巢综合征（polycystic ovarian syndrome，PCOS）合并糖尿病（diabetes mellitus，DM）患者，观察治疗对妊娠结局的影响。 方法 纳入PCOS患者124例，筛选自2015年7月—2017年7月间患者，合并DM，均在该院接受治疗，询问患者意见，获许可后，按来院时间排序编号，经抽签随机确定分组。对照组予单一治疗，研究者予综合治疗，对比两组妊娠结局。 结果 研究组患者1年后妊娠成功率高于对照组，差异无统计学意义（P>0.05）;研究组自然流产率、妊娠高血压发生率及妊娠糖尿病发生率均低于对照组，两组不良妊娠结局发生率差异有统计学意义（P<0.05）。 结论 综合治疗方案能有效改善PCOS合并DM患者的妊娠结局，值得推广。

[关键词] 综合治疗;PCOS;DM;妊娠成功率;不良妊娠结局发生率

[中图分类号] R714.2          [文献标识码] A          [文章编号] 1672-4062（2019）05（b）-0042-02

[Abstract] Objective To observe the effect of comprehensive treatment on pregnancy outcome in patients with polycystic ovarian syndrome （PCOS） and diabetes mellitus （DM）. Methods A total of 124 patients with PCOS were enrolled in this study. From July 2015 to July 2017， patients with DM were selected and treated in our hospital. The patients' opinions were inquired. After obtaining permission， the patients were numbered according to the time of admission and randomly divided into groups by drawing lots. The control group received a single treatment， while the study group received comprehensive treatment. The pregnancy outcomes of the two groups were compared. Results One year later， the success rate of pregnancy in the study group was higher than that in the control group， but there was no statistically significant difference （P>0.05）. The spontaneous abortion rate， the incidence of pregnancy hypertension and the incidence of gestational diabetes in the study group were lower than those in the control group， and the incidence of adverse pregnancy outcomes in the two groups had statistically significant difference （P<0.05）. Conclusion Comprehensive treatment can effectively improve the pregnancy outcome of patients with PCOS and DM， which is worthy of promotion.

[Key words] Comprehensive treatment; PCOS; DM; Pregnancy success rate; Incidence of adverse pregnancy outcomes

PCOS為妇科常见病，患者内分泌异常，会影响妊娠，而若患者合并DM，则不良妊娠结局发生几率也显著提升，对母儿健康与安全均有严重威胁，临床重视疾病治疗[1]。常规治疗以孕激素类药物为主，但效果并不十分理想，综合治疗方案的应用，提升了治疗效果。该研究就PCOS合并DM患者治疗中，实施综合治疗方案的实践价值展开探究，分析2015年7月—2017年7月间该院收治的PCOS患者124例合并DM的临床资料，现报道如下。

1  资料与方法

1.1  一般资料

患者94例，该院接收患者，临床明确诊断，存在PCOS并合并DM。经患者同意，按来院顺序编号，抽签分两组。对照组62例，年龄21～38岁，平均（30.23±2.19）岁，病程6个月～5年，平均（3.12±0.47）年;研究组62例，年龄22～37岁，平均（30.49±2.07）岁，病程8个月～5年，平均（3.17±0.45）年;患者无排卵，确认多囊卵巢病变，符合DM诊断标准[2]，患者对研究所用药物不过敏，未合并其他基础疾病，无流产史、无输卵管堵塞，配偶无生殖障碍，夫妻共同生活，未实施避孕，排除合并心血管疾病、精神系统疾病者，无失访者。研究符合医学伦理，患者知情同意，有关证明文书由患者亲自签署。