母婴专科护理门诊对妊娠期糖耐量异常孕妇的干预效果

Effects of specialist outpatient nursing instruction on gestational impaired glucose tolerance of pregnant women

目的：探讨母婴专科护理门诊对妊娠期糖耐量异常孕妇的血糖、体质量以及妊娠结局的干预效果。方法将2011年3月—2012年1月60例妊娠期糖耐量异常孕妇按照随机数字表法随机分为观察组和对照组，每组各30例。对照组孕妇给予常规的产前检查、孕期教育及孕期营养指导；观察组孕妇在此基础上接受母婴专科护理门诊指导，根据每位孕妇的年龄、体质量、孕周、血糖水平、胎儿宫内生长情况制定个性化的食谱、运动方案，进行一对一咨询和个性化指导。结果干预后，两组孕妇自我管理认知和行为相比，除了饮食控制知晓情况，坚持少食多餐、控制甜食，定时检测血糖这3项外，其他方面比较，差异均有统计学意义（ P＜0．05）。干预后，干预组孕妇在孕32，36，40周和分娩当天餐后2 h血糖与体质量均优于对照组，差异有统计学意义（P＜0．05）。干预后，对照组孕妇妊娠高血压疾病、早产与胎膜早破的发生率分别为13．33％，23．33％，30．00％，均高于观察组，差异有统计学意义（χ2值分别为4．2857，7．9245，5．4545；P＜0．05）。观察组新生儿出生时体质量为（3316．13±364．78）g，高于对照组，差异有统计学意义（t＝2．83，P＜0．01）。结论母婴专科护理门诊干预可有效提高妊娠期糖耐量异常孕妇的自我管理认知和行为，减少妊娠和围产儿并发症的发生。

Objective To explore the effects of specialist outpatient nursing instruction on gestational impaired glucose tolerance （ GIGT ） , body weight and pregnancy outcomes of pregnant women .Methods A total of 60 cases of GIGT pregnant women from March 2011 to January 2012 were randomly divided into experimental group and control group , with 30 cases in each .The control group was given routine antenatal examination, childbirth care guidance from pregnant school , regular diet and exercise instructions and other related knowledge from obstetric nutrition clinic;the experimental group furthermore received maternal and child specialist nursing outpatient guidance . Instructors who had got maternal and child care nurse specialist qualifications issued according to each pregnant woman′s age, weight, gestational weeks, blood glucose, fetal growth, formulated personalized recipes and exercise program , and carried on personalized guidance with one to one counseling .Results After the intervention , other aspects of the self cognition and behavior , except for the diet condition , less sweets control , and regularly blood sugar monitor , had statistical significance （ P〈0 .05 ） . Two-hour postprandial glucose values and weight gain during pregnancy of the experimental group at 32 , 36 and 40 weeks were significantly better than those of the control group （P 〈0.05）.After the intervention, the incidences of gestational hypertension , preterm labor and premature rupture of membranes of the experimental group were 13.33%, 23.33% and 30.00%, respectively, which were significantly lower than those of the control group （χ2 =4.285 7, 7.924 5, 5.454 5, respectively;P〈0.05）.The neonatal birth weight of the experimental group was （3 316.13 ±364.78） g, which was significantly higher than that of the control group （t=2.83, P〈0.01 ）.Conclusions Maternal and child specialist nursing outpatient intervention can effectively improve the GIGT pregnant women′s cognitive and behavioral self-management , reduce blood glucose, body weight levels , and decrease the incidence of pregnancy complications .