三因素三水平正交试验用于运动疗法对妊娠期糖尿病母婴结局的观察

Observation for the effect of three factors and three levels orthogonal test used for exercise therapy intervention outcomes of gestational diabetes maternal and neonatal

目的：观察正交试验用于运动疗法干预对妊娠期糖尿病（GDM）妊娠母婴结局的影响，为制定科学的运动干预方法提供依据。方法纳入我院妇产科GDM产妇216例（GDM组），采用正交试验运动疗法干预加糖尿病健康教育，试验开始前再随机分为运动（A）组和非运动（B）组，比较各组糖尿病曲线下面积（AUC）。另选择同期于我院分娩，糖耐量正常产妇220名（NGT组）。比较两组一般实验室检查资料、BMI、羊水指数、产后出血量、新生儿阿氏评分及并发症等差异。结果通过正交试验运动疗法加糖尿病健康教育干预后，A组AUC为（519．69～650．39）mmol/（L·min），平均（585．65±30．78）mmol/（L·min），B组为（539．19～692．45）mmol/（L·min），平均（614．27±35．45）mmol/（L·min）（P＝0．001）。GDM组FPG、2hPG、HbA1c及BMI较干预前均降低（P＜0．05），与NGT组比较，差异均无显著意义（P＞0．05）。GDM组孕妇羊水过多、早产、胎膜早破、先兆子痫、巨大儿、胎儿窘迫、产后出血发生情况与NGT组比较，差异无显著意义（P＞0．05）；阿氏评分＜7分、剖宫产、妊高症及新生儿黄疸情况与NGT组比较，差异有显著意义（P＜0．05）。结论正交试验用于运动干预加糖尿病健康教育能够改善GDM患者血糖水平，显著改善妊娠结局，并能降低围产儿发病率，对提高护理围产质量具有重要意义。

Objective To observe the effect of orthogonal test used for exercise therapy intervention outcomes of gestational diabetes（GD） maternal and neonatal .Method 216 cases maternity childbirth GD （GD group） in obstetrics and gynecology of our hospital was included in the study .Orthogonal exercise therapy intervention and diabetes health education was used .Patients were randomly divided into exercise group （A） and non-exercise group （B） be-fore the trail .Compared the diabetic area under the curve （AUC） .220 normal puerpera with normal glucose toler-ance （NGT group ） the same year in our hospital were selected for comparison .General laboratory data were meas-ured compared between groups ,such as BMI ,amniotic fluid index ,postpartum hemorrhage ,neonatal Apgar score and complications Result By orthogonal test exercise therapy and diabetes health education intervention ,AUC in group A was 519 .69 ~ 650 .39 mmol/（L · min） with mean （585 .65 ± 30 .78）mmol/（L · min） Group B was 539 .19~692 .45 mmol/（L · min） with mean（614 .27 ± 35 .45）mmol/（L · min） （P= 0 .001） .FPG ,2 hPG , HbA1c and BMI in GD group were much lower than that before the intervention （P〈0 .05） .There was no signifi-cant difference compared with NGT group （P〉0 .05） .Polyhydramnios ,preterm labor ,premature rupture of mem-branes ,pre-eclampsia ,a huge children ,fetal distress ,incidence of postpartum hemorrhage in GDM group was the same as NGT group （P〉0 .05） .There was significant difference in Apgar score〈7 ,cesarean section ,pregnancy-induced hypertension and neonatal jaundice situation between GD group and NGT group （P〈0 .05） .Conclusion Or-thogonal test for exercise intervention and diabetes health education can improve blood sugar levels for patients with GD ,pregnancy outcomes and reduce perinatal morbidity .It＆#39;s very important for the improvement of the quality of perinatal in China .