饮食、运动个性化指导对妊娠期糖尿病的影响

发布时间：2018-03-23 21:34

本文选题：妊娠期糖尿病　切入点：个性化　出处：《河北医科大学》2017年硕士论文

【摘要】：目的:探讨妊娠期糖尿病孕妇膳食营养素摄入情况,饮食、运动干预对妊娠期糖尿病孕妇血糖的预防效果;对孕期孕妇体重状况、妊娠结局的影响。方法:本实验研究对象均选自于2016年2月~12月在邢台市人民医院产科门诊产检确诊为妊娠期糖尿病的24周孕龄的孕妇,共100例。实验分组方式为随机抽签法分为进行饮食、运动个性化指导的干预组和常规护理的对照组各50例。研究对象的膳食摄入情况采用食物频率法进行调查,分析调查对象膳食中能量和营养素的摄入情况。干预组在给予常规护理的基础上,结合各自饮食及运动的不同情况,制定符合个体化的饮食结构和运动方案,给予饮食、运动个性化指导,形式包括家庭访视、门诊干预和电话随访。为对照组研究对象讲解预防糖尿病相关知识,并对其进行一次孕期饮食运动知识宣教。研究对象分别在孕24、28周和分娩前回医院测量体重、空腹血糖和餐后2小时血糖。妊娠结果如剖宫产、新生儿体重、巨大儿、早产、新生儿窒息的资料均来自于病历。结果:本实验共收集干预组48例和对照组49例全部资料。研究显示,干预组和对照组在孕中期每天膳食中的能量和蛋白质、脂肪和糖类三大营养物质,较推荐摄入量相比,能量摄入量偏高,蛋白质的摄入量比较低。进行干预前,干预组与对照组空腹血糖和餐后2小时血糖差异没有统计学意义(P0.05),经过对干预组的营养干预,我们可以发现,干预组空腹血糖和餐后2小时血糖值均较对照组低,差异具有统计学意义(P0.05)。干预组在体重和体重指数方面,比对照组低,但差异无统计学意义(P0.05)。进一步将两组体重及体重指数增长值进行比较,结果显示,干预组比对照组低,差异有统计学意义(P0.05)。将两组剖宫产率展开比较,可以发现两组之间的差异没有统计学意义(P0.05)。干预组巨大儿、早产和新生儿窒息发生率都低于对照组,且有显著性差异(P0.05)。干预组与对照组相比,在新生儿体重方面无显著性差异(P0.05)。结论:1妊娠期糖尿病患者在孕中期膳食中能量摄入量偏高,蛋白质摄入偏低,三大营养素产能比不合理。2孕期饮食运动指导能有效控制孕妇的体重及体重指数的增长。3饮食、运动个性化指导显著改善妊娠期糖尿病血糖水平。4对巨大儿、早产和新生儿窒息的发生率起到降低作用;但是,在干预剖宫产率和新生儿体重方面,还需要进一步探究。
[Abstract]:Objective: to investigate the effect of dietary nutrition intake, diet and exercise intervention on blood glucose of pregnant women with gestational diabetes mellitus, and to evaluate the body weight status of pregnant women with gestational diabetes mellitus. Methods: all the subjects were selected from 24 weeks pregnant women who were diagnosed as gestational diabetes mellitus (GDM) in outpatient department of obstetrics and obstetrics of Xingtai people's Hospital from February to December 2016. A total of 100 patients were divided into diet, exercise individualized instruction intervention group and routine nursing control group by random drawing of lots. The dietary intake of the subjects was investigated by the method of food frequency. The intake of energy and nutrients in the diet of the subjects was analyzed. On the basis of routine nursing care, the intervention group made the diet structure and exercise plan according to the different conditions of their diet and exercise, and gave them diet. Exercise individualized instruction, in the form of family visit, outpatient intervention and telephone follow-up. The subjects measured their body weight, fasting blood glucose and 2 hours postprandial blood glucose at 2428 weeks of pregnancy and before delivery. The results of pregnancy such as cesarean section, newborn weight, macrosomia, premature delivery, Results: the data of 48 cases in the intervention group and 49 cases in the control group were collected. The study showed that the energy and protein in the daily diet of the intervention group and the control group in the second trimester of pregnancy. Compared with the recommended intake, the three nutrients of fat and sugar are higher in energy intake and lower in protein intake. There was no significant difference in fasting blood glucose and 2 hours postprandial blood glucose between the intervention group and the control group (P 0.05). After nutritional intervention in the intervention group, we could find that the fasting blood glucose and 2 hours postprandial blood glucose in the intervention group were lower than those in the control group. The difference was statistically significant (P 0.05). The body mass index (BMI) of the intervention group was lower than that of the control group, but there was no significant difference between the two groups. Further comparison was made between the two groups. The results showed that the intervention group was lower than the control group. The difference was statistically significant (P 0.05). By comparing the cesarean section rate between the two groups, it was found that there was no significant difference between the two groups. The incidence of macrosomia, premature delivery and neonatal asphyxia in the intervention group was lower than that in the control group. There was no significant difference in neonatal body weight between the intervention group and the control group (P 0.05). Conclusion the dietary energy intake and protein intake of gestational diabetes mellitus patients with gestational diabetes mellitus during the second trimester of pregnancy were higher and protein intake was lower in the intervention group than in the control group. The three main nutrients production capacity ratio is unreasonable. 2. Exercise guidance during pregnancy can effectively control the increase of body mass and body mass index of pregnant women, and exercise individualized instruction can significantly improve the blood glucose level of gestational diabetes mellitus (GDM) and improve the macrosomia of gestational diabetes mellitus (GDM). The incidence of premature birth and neonatal asphyxia has been reduced; however, further research is needed in terms of intervention in cesarean section and neonatal weight.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.256

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