昆明学院双语查房2015-妊娠期糖尿病VIP专享VIP免费

12/24/2412/24/24指导老师：徐建阮海英刘春梅承办：妇产儿教研组♠床号：22床♠姓名：翟艳♠住院号：1470825♠年龄：29岁♠入院时间：2014年07月12日15时00分♠诊断：♠1、G1P0孕39+5周头位临产；♠2、妊娠期糖尿病一、病历基本情况(basicinformationofthepatient).♣Bedno.22♣Name：ZhaiYan♣AD：1470825♣Age：29♣Admissiontime：July12,2014,15♣Diagnosis：♣1、G1P0,39+5weeksofgestation,headinlabor；♣2、diabetesduringpregnancy♠主诉（Mainsuit）：停经9月余，发现血糖异常3月余，临预产Menelipseover9months,bloodsugarabnormalover3monthsandtheduedatedrawsnear.♠现病史（medicalrecord）：此次第1次怀孕，平素月经规律正常。LMP：2013年10月07日。孕1月余自测尿HCG阳性，孕2月至我院行B超示宫内妊娠。孕2月开始有恶心、呕吐、厌食等症状，3月时消失。孕4月自觉胎动至今。孕期无头痛、头晕、心悸、胸闷史。Itisthefirsttimepregnancy.ThelastmenstrualcycleswasonOctober7,2013.TheHCGshowspositivewhenshetestedafteronemonthpregnancy.♣简易OGTT血糖为：5.77mmol/L11.12mmol/L8.75mmol/L♣OGTTshowsbloodsugar:5.77MilliMooreperliter，11.12MilliMooreperliter，8.75MilliMooreperliter。♠家族史(Thefamilyhistory)：母亲患有糖尿病。♠Thefamilyhistory:motherhavediabetes.LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests实验室检查LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests50g葡萄糖+200ml水一小时后抽血糖筛查:糖筛查:糖筛查>7.8mmol/L>11.2mmol/L正常糖筛查异常GDM可能性大OGTT空腹血糖确诊LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests实验室检查LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests50gglucose+200mlwaterBloodinanhourSugarscreening>7.8mmol/L>11.2mmol/LnormalabnormalGDMmorelikelyOGTTFastingglucoseconfirmed翟女士我院产检时行OGTT血糖为：5.77mmol/L，11.3mmol/L，8.75mmol/L。4、肝肾功能检查，24小时尿蛋白定量，尿酮体及眼底等相关检查；实验室检查LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests禁食12小时，取空腹血，再用300毫升水冲75克葡萄糖口服，服糖后1、2、3小时取血空腹1小时2小时3小时国际5.610.38.66.7OGTT两点异常，确诊为GDM；一点异常诊为妊娠期糖耐量异常禁食12小时，取空腹血，再用300毫升水冲75克葡萄糖口服，服糖后1、2、3小时取血空腹1小时2小时3小时国际5.610.38.66.7OGTT两点异常，确诊为GDM；一点异常诊为妊娠期糖耐量异常糖耐量（OGTT）糖耐量（OGTT）Ms.ZhaifromtheirprenatalOGTTbloodsugarfor:5.77mmol/L，11.3mmol/L，8.75mmol/L。4、Quantitativekidneyfunction,24hoururineprotein,urineketonebodyandfundusexaminationrelatedto;实验室检查LaboratorytestsLaboratorytestsLaboratorytestsLaboratorytests糖耐量（OGTT）糖耐量（OGTT）Takingonanemptystomachbloodfasting12hours,andthenwith300mlwater,75goralglucose,1,2,3hoursaftertakingsugarinbloodemptystomach1h2h3h5.610.38.66.7AbnormalOGTTattwoo'clock,diagnosedwithGDM;AbitofanomalydiagnosedasabnormalglucosetoleranceduringpregnancyTakingonanemptystomachbloodfasting12hours,andthenwith300mlwater,75goralglucose,1,2,3hoursaftertakingsugarinbloodemptystomach1h2h3h5.610.38.66.7AbnormalOGTTattwoo'clock,diagnosedwithGDM;Abitofanomalydiagnosedasabnormalglucosetoleranceduringpregnancy12/24/24PhysicalcheckPhysicalcheck体格检查GestationaldiabetesmellitusGestationaldiabetesmellitusDiagnosedwithdiabietesbeforepregnancyDiagnosedwithdiabietesbeforepregnancyPregnancyassociatedwithdiabetesPregnancyassociatedwithdiabetes妊娠期首次发病或发现的糖尿病，包含了一部分妊娠前已患有糖尿病但孕期首次被诊断的病人。妊娠期首次发病或发现的糖尿病，包含了一部分妊娠前已患有糖尿病但孕期...