糖尿病教育在改善妊娠期糖耐量降低孕妇妊娠结局中的作用

Impact of nurse based diabetes education program in the management of women with gestational impaired glucose tolerance

为了探讨糖尿病教育在改善妊娠期糖耐量降低血糖控制与妊娠结局中的作用 ,本研究采用类实验研究设计 ,方便取样(n =16 7) ,设立糖尿病干预组、糖尿病对照组和正常对照组 ,观察糖尿病干预组接受糖尿病教育前后知信行的变化 ,比较 3组的妊娠结局。结果 :糖尿病干预组在接受教育前后相关知识和疾病控制行为有了显著的改善。糖尿病干预组孕末期餐后 2小时血糖与糖尿病对照组相比有显著改善。糖尿病干预组妊高征和巨大儿的发生率显著低于糖尿病对照组 ,与正常组接近 ,新生儿 1分钟Apgar评分显著高于糖尿病对照组。结论 :糖尿病教育对改善妊娠期糖耐量降低孕妇的血糖控制和妊娠结局有积极作用。以糖尿病教育护士为主导的教育和咨询服务 ,可弥补我国传统的妊娠期糖耐量降低孕妇管理模式的不足 。

In order to investigate the impact of a nurse based diabetes education program on the management of women with gestational impaired glucose tolerance, a quasi experimental design and convenience sampling ( n =167) was adopted. A diabetes intervention (DI) group, a diabetes control(DC) group and a normal control(NC) group were set up. The pre education and post education diabetes knowledge levels, anxiety and depression levels, and self management behaviors of the DI group were observed and compared. Abnormal outcomes in the 3 groups were observed and compared. The results showed that in the DI group,the post education diabetes knowledge level and self management behavior were improved significantly compared with those pre education, and in the DI group,the postprandial blood glucose level during the end period of the pregnancy was improved significantly compared with the level during the second period (8.79+1.94mmol/L vs. 6.84+ 1.38 mmol/L). The incidences of pregnancy induced hypertension (PIH) and macrosomia in the DI group were significantly lower than those of the DC group, and similar to those of the NC group. The 1 minute Apgar scores of the infants in the DI group were significantly higher than those in the DC group. It was concluded that diabetes education had a positive impact on the control of blood glucose levels and improving the pregnant outcomes, and that a nurse based education and counseling system could complement the current diabetes care in women with gestational impaired glucose tolerance.