以一日门诊为基础的综合管理模式对妊娠期糖尿病患者的效果研究

发布时间：2018-03-19 12:46

本文选题：糖尿病　切入点：妊娠　出处：《中国全科医学》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨以一日门诊为基础的综合管理模式对妊娠期糖尿病(GDM)患者体质量、血糖、母婴并发症的影响。方法选取2013年12月—2015年12月于浙江大学医学院附属妇产科医院确诊为GDM患者1 870例为研究对象,根据自愿原则,920例纳入对照组,950例纳入研究组。对照组采用常规管理干预模式;研究组采用以一日门诊为基础的综合管理模式,主要内容包括GDM相关知识宣教,医学营养治疗相关知识介绍,饮食、运动、血糖监测指导。采用自制测试问卷评价两组GDM患者GDM相关知识认知情况,记录妊娠前及产前体质量、体质指数(BMI),记录干预前后空腹血糖、餐前血糖、餐后2 h血糖水平,以及围生期并发症、围生儿并发症的发生率。结果研究组GDM患者基础知识、母婴危害、饮食知识、运动知识、血糖监测、体质量管理及格率均高于对照组(P0.05)。研究组GDM患者妊娠期体质量、BMI增长量均低于对照组(P0.05)。干预后,研究组GDM患者空腹血糖、餐前血糖、餐后2 h血糖水平均低于对照组(P0.05);两组干预后空腹血糖、餐前血糖、餐后2 h血糖水平均低于干预前(P0.05)。研究组妊娠期高血压疾病、羊水过多、产后出血、巨大儿、新生儿窒息、新生儿低血糖发生率均低于对照组(P0.05)。结论以一日门诊为基础的综合管理模式可提高GDM患者对疾病的认知,控制体质量增长,维持血糖稳定,降低母婴不良妊娠结局的发生风险。
[Abstract]:Objective to explore the effect of comprehensive management model based on 1st outpatient service on the body mass and blood sugar of patients with gestational diabetes mellitus (GDM). Methods from December 2013 to December 2015, 1 870 patients with GDM were selected from the affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical College. According to the voluntary principle, 920 cases were included in the study group, 920 cases in the control group were included in the study group, the control group adopted the conventional management intervention model, and the study group adopted the comprehensive management model based on the outpatient service in 1st, the main content of which included GDM related knowledge education. Medical nutrition therapy related knowledge introduction, diet, exercise, blood glucose monitoring guidance. The self-made test questionnaire was used to evaluate the knowledge and cognition of GDM in the two groups of GDM patients, and recorded the pre-pregnancy and prenatal body mass. Body mass index (BMI) was used to record fasting blood glucose, preprandial blood glucose, postprandial blood glucose level, perinatal complications, perinatal complications and incidence of perinatal complications before and after intervention. Results the basic knowledge, maternal and child harm, diet knowledge of GDM patients in the study group were recorded. Exercise knowledge, blood glucose monitoring, body mass control pass rate were higher than control group (P 0.05). The increase of gestational body mass in study group was lower than that in control group (P 0.05). After intervention, fasting blood glucose and preprandial blood sugar were increased in study group GDM patients. The levels of blood glucose at 2 h after meal were lower than those in control group (P 0.05), fasting blood glucose, preprandial blood glucose and 2 h postprandial blood glucose in both groups were lower than those before intervention. The study group had hypertensive disorder complicating pregnancy, amniotic fluid excess, postpartum hemorrhage, macrosomia and neonatal asphyxia. Conclusion the comprehensive management model based on 1st outpatient clinic can improve the cognition of disease, control body quality, maintain stable blood sugar and reduce the risk of adverse pregnancy outcome in GDM patients.
【作者单位】：浙江大学国际医院妇产科;浙江大学医学院附属妇产科医院妇产科;
【分类号】：R714.256

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