| Objective:Gestational diabetes refers to any degree of abnormal glucose tolerance that occurs or is diagnosed for the first time during pregnancy,excluding patients with previous diabetes.Hyperglycemia state during pregnancy has a great impact on both mothers and infants,and it increases the rate of cesarean section in patients with GDM.The maternal preoperative state directly affects the newborn through the placenta and umbilical cord,so it is of great significance to adjust the preoperative state of the parturient.The purpose of this study is to observe the effect of sodium potassium magnesium calcium and glucose injection on blood glucose and lactate of pregnant women and newborns before cesarean section in GDM patients,in order to provide help for the perioperative diabetes blood glucose stability and maternal and child safety during pregnancy.Methods:From September 2017 to September 2018,60 pregnant women with GDM who met the inclusion criteria were selected for cesarean section in this hospital.They were randomly divided into sodium potassium magnesium calcium glucose injection group(experimental group)and sodium lactate Ringer's solution group(control group),30 patients per group.After entering the pre-anesthesia room,routinely monitor vital signs,record the basic values of maternal systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and blood oxygen saturation(Sp O2).After the venous access was opened,In total of 10ml/kg of sodium potassium magnesium calcium and glucose injection were Infusion to the patients in the experimental group and sodium lactate Ringer's solution were Infusion to the patients in the control group for preloading.Anaesthesia was performed after preloading infusion.The patients in both groups were infused with normal saline at the rate of 10ml/kg/h until the end of operation.The method of anesthesia was combined spinal-epidural anesthesia,adjust the anesthesia plane at T6 level.The blood gas of radial artery of parturient was analyzed at the time of entering the room(T0),the time of breaking the umbilical cord(T1)and the time of the end of operation(T2),and the blood glucose value and blood lactate value were recorded.At the time of T1,the blood gas of umbilical artery and umbilical vein were record,and the blood glucose and lactate were observed and recorded.30 minutes after the delivery,blood glucose was measured by collecting heel blood and the incidence of hypoglycemia were record.Results:1 There was no significant difference in age,height,weight,blood pressure,heart rate,operation time and blood loss between the two groups(P>0.05).2 Comparison of radial artery blood glucose value and blood lactate value:2.1 Blood glucose value:compared with the two groups of the blood glucose value of T0,there was no significant difference(P>0.05).Compared with the blood glucose value of T0,the blood glucose values of T1 and T2 in the experimental group were higher,the difference was statistically significant(P<0.05).The blood glucose values of T1 and T2 in the experimental group were significantly higher than those in the control group(P<0.05).2.2 Blood lactate value:compared with the two groups of the blood lactate value of T0,there was no significant difference(P>0.05).There was no significant difference in the blood lactate level of the experimental group at each time point(P > 0.05).Compared with T0,the blood lactate level of T1 and T2 in the control group was significantly higher(P<0.05).Compared with the two groups of the blood lactate level of T1 and T2 in the experimental group was significantly lower than that in the control group(P<0.05).3 Comparison of Umbilical Cord Blood Glucose and Lactate in Two Groups:compared with the control group,the blood glucose values of umbilical artery and umbilical vein in the experimental group were higher,the difference was statistically significant(P<0.05).The blood lactate value of umbilical artery and umbilical vein in the control group was higher than the experimental group,the difference was statistically significant(P<0.05).4 The blood glucose value of heel capillaries in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P<0.05);The incidence of hypoglycemia and critical hypoglycemia in the experimental group were 10.0% and 26.7% respectively,which were significantly lower than the control group(30.0% and 43.3%)(P<0.05).Conclusion:Infusion of 10ml/kg sodium potassium magnesium calcium and glucose injection before cesarean section in parturient with GDM can improve the blood glucose level of both parturients and newborns.It is more in line with the physiological needs of parturients with GDM and newborns,making parturients with GDM blood glucose more stable and safer for parturients with GDM and newborns. |
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